The role of simple elbow dislocations in cubitus valgus development in children

Abstract

Purpose: We investigated the functional and radiological outcomes of conservatively treated simple traumatic elbow dislocations and subsequent incidence of cubitus valgus development in children.

Methods: Eleven patients (one female, ten male; mean age 9.8 years, range seven to 12 years) who presented to our hospital with simple elbow dislocations and were conservatively treated between July 2008 and September 2010 were included in the study. All were posterolateral closed dislocations. None of the patients had accompanying elbow fractures. All patients had pre- and postoperative radiographic examinations. The carrying angle of the involved elbow was measured and compared to the contralateral non-injured elbow during follow-up. The incidence and severity of cubitus valgus development was assessed. The functional and clinical outcomes were evaluated using the Mayo Elbow Performance Scale. The mean monitoring period was 24.3 months (range 19-30 months).

Results: All patients had satisfactory good and excellent results (85-100 points; mean 96.8 points) according to the Mayo Elbow Performance Scale. The final average elbow flexion was 137° (range, 130-145°) and average extension was 8.6° (range 0-20°) with full supination and pronation in traumatic elbow. Four patients (36.4%) had an average increase (cubitus valgus) of 14.5° (10-20°) in carrying angle compared to the other elbow.

Conclusions: While isolated traumatic dislocation of the elbow is uncommon among children, it can be successfully treated by urgent closed reduction, proper fixation of the elbow and appropriate timely rehabilitation. However, it should be considered that some patients may develop cubitus valgus deformity in a later period. Therefore, each patient with a simple traumatic elbow dislocation should be followed, and the parents should be informed of the potential for any deformity development.

Fig. 1

a AP and Lateral X-rays of an 11-year-old boy with simple traumatic left elbow dislocation (pre-reduction). b. Lateral X-rays of an 11-year-old boy with simple traumatic left elbow dislocation (post-reduction)

Fig. 2

Photos of the same patient as in Fig. 1 demonstrating 20° of cubitus valgus deformity

Fig. 3

AP and Lateral X-rays of the same patient as in Figs. 1 and 2 during follow-up in the 26th month

Fig. 4

CT and MR images of the same patient