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. 2012 Aug;4(3):177-81.
doi: 10.1111/j.1757-7861.2012.00190.x.

Management of neglected elbow dislocations in a setting with low clinical resources

Somirul Islam  1 , Jabed Jahangir, Rakib Mohammad Manzur, Ahm Asgar Ali Chowdury, Nayan Tripura, Ajoy das
Affiliations

Management of neglected elbow dislocations in a setting with low clinical resources

Somirul Islam et al. Orthop Surg. 2012 Aug.

Abstract

Objective: To investigate the effect of open reduction operative treatment in neglected elbow dislocation.

Methods: Between January 2009 and October 2010, 13 patients (mean, 27 years, nine men and four women) with old unreduced posterior dislocation of the elbow were treated by open reduction and removal of fibrous tissue between distal humerus and ulna with Kirschner wire fixation with or without triceps lengthening in our hospital.

Results: The patients were followed up for a mean of 18 (range, 14-22) months. The mean operating time was 69.53 (range, 56-90) min. Mean operative blood loss 361.53 mL (range, 300-450 mL), mean tourniquet time 51.92 min (range, 46-70 min). According to the Mayo Elbow Performance Index at the final follow-up, 11 patients had satisfactory outcomes (six excellent, five good) and two patients had unsatisfactory outcomes (one fair and one poor). The mean score was 87. Nine patients had no pain, two had mild pain during repetitive elbow movements or weight lifting, and two had moderate pain. The mean pain score was 38 (range, 15-45). At the final follow-up, two patients had signs of instability; the mean score was 15. Seven achieved a flexion range of 105° to 130°, two achieved 100°, two achieved 95°, one achieved 80°, and one 60°.

Conclusion: Operative treatment of late-presenting, unreduced elbow dislocation is effective in restoring the joint to a painless, stable and functional limb.

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Figures

Figure 1
Figure 1
The preoperative X‐ray, showing the dislocation of left elbow, distal humerus was prominent anteriorly, and the olecranon was prominent posteriorly.
Figure 2
Figure 2
The postoperative X‐ray showing the fractured radial head was excised, the olecranon was transfixed to the distal humerus in 90° flexion of the elbow using Kirschner wire. Concentric reduction and anatomic alignment of the ulno‐humeral was achieved in the patients.
Figure 3
Figure 3
Postoperative range of motion, the affected elbow achieved a flexion range of 130° 2 years after the operation.
Figure 4
Figure 4
Postoperative range of motion, the affected elbow achieved a nearly normal extension 2 years after the operation.
See this image and copyright information in PMC

References

    1. Jupiter JB. Trauma to the adult elbow fractures of the distal humerus In: Browner BD, Levine AM, Trafton PG, eds. Skeletal Trauma. Philadelphia: Saunders, 1992; 1141.
    1. King GJW. The complex dislocations of the elbow In: Celli A, Celli L, Morrey BF, eds. Treatment of Elbow Lesions. Milan: Springer, 2007; 1033.
    1. Naidoo KS. Unreduced posterior dislocations of the elbow. J Bone Joint Surg Br, 1982, 64: 603–606. - PubMed
    1. Freeman BL III. Old unreduced dislocations In: Crenshaw AH, ed. Campbell's Operative Orthopaedics, 9th edn St. Louis: Mosby, 1998; 2673–2674.
    1. Mehta S, Sud A, Tiwari A, et al Open reduction for late‐presenting posterior dislocation of the elbow. J Orthop Surg, 2007, 15: 15–21. - PubMed