1. Arthroscopic Treatment of Annular Drive Through and Radial Lateral Collateral Ligament Articular-Side Tear of the Elbow 
Paolo Arrigoni, M.D., Riccardo D’Ambrosi, M.D., Pietro Randelli, M.D. 
Arthroscopy Techniques 
Volume 4, Issue 6, Pages e647-e650 (December 2015)
DOI: /j.eats
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
The patient is placed in a modified lateral decubitus position with the operative arm positioned at 100° of flexion and 90° of abduction at the level of the shoulder using an arm holder. The elbow is positioned at 90° of flexion, with the forearm hanging free to gravity.
Arthroscopy Techniques 2015 4, e647-e650DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
Arthroscopic view from the posterolateral portal with a 30° arthroscope. In this position, it is possible to introduce the shaver blade between the radial head and the annular ligament through the midlateral portal. This sign is named the annular drive through.
Arthroscopy Techniques 2015 4, e647-e650DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
Arthroscopic view from the anteromedial portal with a 30° arthroscope. It is possible to appreciate a partial articular-sided lesion of the lateral collateral ligament in its radial component.
Arthroscopy Techniques 2015 4, e647-e650DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

5. Fig 4
Arthroscopic view from the anteromedial portal with a 30° arthroscope. A 5.0-mm double-loaded metallic suture anchor is inserted through the anterolateral portal at the level of the lateral aspect of the capitellum.
Arthroscopy Techniques 2015 4, e647-e650DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

6. Fig 5
Arthroscopic view from the anteromedial portal with a 30° arthroscope. After all the sutures have been managed, the radial lateral collateral ligament is secured to the bone.
Arthroscopy Techniques 2015 4, e647-e650DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

7. Fig 6
Arthroscopic view from the posterolateral portal with a 30° arthroscope showing elimination of the annular drive-through sign between the radial head and the annular ligament.
Arthroscopy Techniques 2015 4, e647-e650DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions