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Objective  To compare the effects of repairing and not repairing the lateral ulnar collateral ligament (LUCL) when surgically treating elbow varus posteromedial rotatory instability (PMRI).    Methods  In this retrospective study spanning June 2014 to February 2019, 24 patients with elbow PMRI who were treated surgically were assigned to group RL (Repair LUCL) or group NL (Non‐repair LUCL) depending on whether the LUCL was repaired. Hospitalization time, operation time, intraoperative blood loss, and related complications were reviewed. The elbow range of motion (ROM), the visual analog scale (VAS), the Mayo elbow performance score (MEPS), and the disabilities of the arm, shoulder, and hand (DASH) score were used for functional assessment.    Results  Among the 24 patients with PMRI, 15 were assigned to group RL and nine were assigned to group NL. The mean blood loss (184.66 ± 20.3  vs  207.33 ± 19.447,  P  < 0.001), the operation time (98.88 ± 12.693 min  vs  184.66 ± 20.3 min,  P  < 0.001) were significantly lower in group RL compared to group NL. There were no significant differences between the two groups in time until surgery and follow‐up time (6.66 ± 1.838  vs  6.11 ± 1.900 days, 25.53 ± 2.099  vs  26.11 ± 2.891 months,  P  = 0.577,  P  = 0.486). All of the patients achieved bone union. The elbow flexion‐extension ROM (122.00° ± 3.162° vs  121.11° ± 3.333° at 12 months,  P  = 0.520) and pronation‐supination ROM (154.53° ± 3.335°  vs  155.55° ± 4.639° at 12 months,  P  = 0.537). Both groups achieved similar results in MEPS score (90.53 ± 2.695  vs  89.77 ± 3.865,  P  = 0.578) and DASH (9.77 ± 1.897  vs  9.99 ± 1.550,  P  = 0.772) score at the final follow‐up. And the MEPS score revealed excellent results (87% in group RL, 89% in group NL).The VAS scores decreased significantly in group RL (from 6.13 ± 0.990 to 1.93 ± 0.593) and group NL (from 5.77 ± 1.481 to 1.88 ± 0.781), and no significant differences in preoperative or final follow‐up were observed between the two groups ( P  = 0.487,  P  = 0.876). Complications observed in group NL with one patient occurred cubital tunnel syndrome 3 months after the operation, the patient underwent ulnar nerve simple neurolysis and the symptoms were relieved after 3 weeks.    Conclusion  For patients with elbow PMRI, satisfactory functional outcomes can be yielded with non‐repair of the LUCL as long as the stable elbow joint is performed during operation.

Repair Versus Non‐Repair of Lateral Ulnar Collateral Ligament in Elbow Varus Posteromedial Rotatory Instability Treatment: A Comparative Study