Early Outcome of Open Reduction and Cross Kirschner’s Wire Fixation of Neglected Elbow Dislocation
A Case Series
Keywords:
Pannus, reduction, triceps lengtheningAbstract
Background: Neglected dislocation of the elbow joint is mainly seen in developing countries and is not uncommon. It is usually associated with marked reduction in the range of movement and functional impairment. Although it presents a surgical challenge, open reduction is routinely indicated. Materials and Methods: This was a retrospective study over a 3‑year period (June 2017 to June 2020) that included patients presenting with a neglected elbow dislocation. A total of seven patients (six females and one male) met the inclusion criteria. A posterior triceps splitting approach was used in all the patients with one patient requiring triceps lengthening. Results: Reduction was achieved in all seven cases. There was a statistically significant difference between the preoperative range of motion (14.29 ± 3.45) when compared to the postoperative range of motion (102.86 ± 16.04). Conclusion: Neglected old elbow dislocation, a pathology seen mainly in developing countries, can be managed by open reduction and cross Kirschner’s wire fixation.
References
1. Freeman BL 3rd. Old unreduced dislocations. In: Creshaw AH, editor. Campbell’s Operative Orthopedics. 9th ed., Vol. 1. St Louis: Mosby;1998. p. 2673‑4.
2. Rockwood CA. Treatment of old unreduced dislocation of the elbow. In: Rockwood CA, editor. Rockwood and Green’s Fracture in Adults. 4th ed., Vol. 1. Philadelphia, PA: Lippincot‑Raven; 1996. p. 975‑6.
3. Kachnerkar NI, Lackde N, Salokher S. Neglected old posteriordislocation of the elbow: Treatment and results of open reduction. IJOS2017;3:1062‑6.
4. Devnani AS. Outcome of longstanding dislocated elbow treated byopen reduction and excision of collateral ligaments. Singapore Med J2004;45:14‑9.
5. Mehta S, Sud A, TIwari A, Kapoor SK. Open reduction for latepresenting posterior dislocation of the elbow. J Orthop Surg (Hong Kong)2007;15:15‑21.
6. di Schino M, Breda Y, Grimaldi FM, Lorthioir JM, Merrien Y. Surgicaltreatment of neglected elbow dislocations. Report of 81 cases. Rev ChirOrthop Reparatrice Appar Mot 1990;76:303‑10.
7. Ivo R, Mader K, Dargel J, Pennig D. Treatment of chronically unreducedcomplex dislocations of the elbow. Strategies Trauma Limb Reconstr2009;4:49‑95.
8. Kachnerkar NI, Lakde N, Salokhe S. Neglected old posterior dislocationof the elbow: Treatment and results of open reduction. Int J Orthop Sci2017;3:1062‑6.
9. Speed JS. An operation for unreduced posterior elbow dislocation of theelbow. South Med J 1925;18:193‑8.
10. Vangorder GW. Surgical approach in old posterior dislocation of theelbow. J Bone Joint Surg Am 1932;14:127‑43.
11. Mahaisavariya B, Lavpattarakasem W. Neglected dislocation of theelbow. Clin Orthop Relat Res 2005;431:21‑5.
12. Rubino JL, Herbenick MA, Finnan RP, Antoague PA. Chronic elbowdislocation treated with open reduction and lateral ulnar collateralligament reconstruction. Am J Orthop 2009;28:98‑100.
13. Krishnamoorthy S, Bose K, Wong KP. Treatment of old unreduceddislocation of the elbow. Injury 1976;8:39‑42.
14. Naidoo KS. Unreduced posterior dislocation of the elbow. J Bone JointSurg Br 1982;64:603‑6.
15. Mahaisavariya B, Lavpattarakasem W, Supachutikil A, Taesiri H,Sujaritbudhungkoon S. Late reduction of the dislocated elbow. Needtriceps be lengthened? J Bone Joint Surg Br 1993;75:426‑8.
16. Maheswaran KS, Kamalanathan K. Management of old unreducedposterior dislocation of elbow: Results of open reduction. IOSR J DentMed Sci 2016;15:8‑11.
17. Coulibaly NF, Tiendjo H, Sane AD, Sarr YF, Ndiaye A, Seye S. Posteriorapproach for surgical treatment of neglected elbow dislocation. OrthopTraumatol Surg Res 2012;98:552‑8.
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Copyright (c) 2021 Obinna Henry Obiegbu (Author)
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