Anterior elbow dislocation without fracture in an adult: a rare injury pattern

Abstract

Anterior elbow dislocation without periarticular fracture (simple dislocation) is an extremely rare injury and is usually caused by distraction or torsional forces. It is important to look for associated ligamentous and musculotendinous injuries in this pattern. We report an elderly patient who sustained simple anterior dislocation of the elbow and in whom successful closed reduction could be achieved. Reduction by closed method is possible if we know the exact mechanism of elbow injury. Despite the presence of medial collateral ligament injury, he was managed non-operatively and had full functional recovery. Checking for joint stability and collateral ligaments after reduction and getting additional radiological investigations help in better treatment planning. Early protected active mobilisation should be initiated to achieve better functional results.

Keywords: elbow fracture; elbow instability; injuries; joint interposition; ligament rupture.

Figure 1

Anteroposterior and lateral radiographs of the left elbow showing anterior dislocation without associated periarticular fractures (A), immediate post-reduction radiographs showing concentric reduction of the joint (B) and coronal (C) and axial (D) MRI images of distal humerus showing injury to the medial collateral ligament and the common flexor origin (arrow marks).

Figure 2

Anteroposterior and lateral radiographs of the left elbow taken 3 years after the trauma showing no evidence of residual instability, avascular necrosis or arthritis (A) and clinical photograph showing near comparable range of movement of elbows and full supination of forearms (B).