Abstract
Background: Chronic elbow dislocations are rare injuries that present late for orthopaedic management. The delay in presentation is frequently due to patients not seeking treatment after the initial injury, poor access to health care, inadequate initial treatment of acute dislocation or initial missed diagnosis. Chronic simple elbow dislocations refer to dislocations that remain unreduced for more than two weeks and are not associated with fractures. This study aims to evaluate the outcome of surgically treated chronic elbow dislocations. Methods: A retrospective review of all patients who were treated for chronic simple elbow dislocations between September 2009 and August 2014 was undertaken. Further information regarding return to function was obtained from the records or telephonic consultation with the patients. Nine patients were included for final analysis. Results: Nine patients were eligible for the study. Three patients were employed, three were scholars and three were unemployed. All patients were able to return to premorbid function with minor limitations due to occasional pain. According to the Mayo Elbow Performance Index (MEPI) score, two patients had excellent outcomes, three good and three fair. One could not be scored as there was no recorded scoring on the file and telephonic contact was unsuccessful. The range of motion varied from 20° of extension to 140° of flexion. One patient developed a stiff elbow but was able to adapt to activities of daily living. Conclusion: Surgical treatment of chronically unreduced simple elbow dislocations offers satisfactory outcome with minimal complications and should be considered for all patients presenting with this condition. Level of evidence: Level 4
Highlights
Chronic elbow dislocations are rare injuries that present late for orthopaedic management
This study aims to report patient satisfaction following surgical treatment of chronic simple elbow dislocations, evaluate return to premorbid function and gather information that may help in preoperative counselling of patients in terms of the expected outcomes of surgery and rehabilitation
Twenty patients with chronic elbow dislocations were treated during the study period
Summary
Chronic elbow dislocations are rare injuries that present late for orthopaedic management. The delay in presentation is frequently due to patients not seeking treatment after the initial injury, poor access to health care, inadequate initial treatment of acute dislocation or initial missed diagnosis. Conclusion: Surgical treatment of chronically unreduced simple elbow dislocations offers satisfactory outcome with minimal complications and should be considered for all patients presenting with this condition. Despite the frequency of acute elbow dislocations, chronic elbow dislocations are rare.[1,2] Patients with chronic elbow dislocations are frequently the result of their not seeking treatment after the initial injury, poor access to health care, inadequate initial treatment of acute dislocation or initial missed diagnosis.[1,2,3]. Neglected (chronic) elbow dislocations are defined as dislocations left unreduced for more than two weeks.[1,2,3,4] These injuries are uncommon in developed countries,[5] but more frequently encountered in developing countries.[3,6] Dislocations without concomitant fractures are termed ‘simple dislocations’ while dislocations that are associated with fractures of the coronoid process, radial head or neck, distal humerus or olecranon are termed ‘complex dislocations’.2
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