Outcomes after surgical stabilization of chronic traumatic elbow dislocations

Abstract

Background: Several surgical protocols have been described for reduction and stabilization of chronic, posttraumatic elbow dislocations. These are supported by small case series only, and treatment recommendations remain inconclusive. Our purpose was to evaluate the outcomes of surgical treatment in a series of chronic, posttraumatic elbow dislocations at our institution. Methods: We retrospectively reviewed the charts of all patients with chronic elbow dislocations treated with a stabilization procedure. We identified 10 patients (average dislocation duration 39.6 wk) with an average follow-up at our institution of 26 mo (4 to 55 mo). Results: Five women and five men with prior elbow dislocations (two simple, eight complex; five terrible triad, three Monteggia, two Essex-Lopresti) were included. Six patients had undergone one or more unsuccessful stabilization procedures at an outside hospital. At our institution, the patients were treated with a surgical stabilization protocol tailored to their injury. At final follow-up, eight patients had a stable, concentrically reduced elbow and regained a painless, functional arc of motion. Two patients with type III coronoid fractures that could not be reconstructed had recurrent dislocations. Six patients required medial collateral ligament reconstruction to maintain stability, suggesting that medial collateral ligament injury contributed to persistent elbow instability. Conclusions: In our series, a stable and painless elbow with a functional arc of motion was restored in eight of 10 patients with chronic elbow dislocations. The presence of a type III coronoid fracture increased the risk of failure. Level of Evidence: Level IV, Case Series.