Abstract
IntroductionElbow dislocations in children are uncommon injuries. Dislocations with associated fractures or so-called complex dislocations of the elbow can be challenging to diagnose and treat.Case presentationA 14-year-old male had a posterolateral elbow dislocation after a fall. Closed reduction with traction was performed. Radiographs after initial reduction showed a fragment entrapped into the humero-cubital joint. Computerized tomography scan showed the fragment belonging to the medial epicondyle. Open reduction and internal fixation with a 3.0 millimeter cannulated screw was performed, with restoring of the normal function of the elbow at final follow up.ConclusionElbow dislocations in children can be associated with bone lesions. These injuries must be suspected to avoid misleading diagnosis and achieve good results.
Highlights
Elbow dislocations in children are uncommon injuries
Radiographs after initial reduction showed a fragment entrapped into the humero-cubital joint
Computerized tomography scan showed the fragment belonging to the medial epicondyle
Summary
Traumatic dislocation of the elbow is rare in children with an incidence of only 3% to 6% of all elbow injuries. Examination revealed no possibility of passive flexion or extension through the elbow joint and valgus instability. A CT scan was performed revealing the intraarticular fragment belonging to the medial epicondyle (Figure 3A & 3B). Intraoperative testing revealed stability of the joint in the entire range of motion and varus and valgus stress. A posterior above-elbow splint with the elbow joint in 90o of flexion and neutral rotation was applied for 7 days followed by early motion and a physiotherapy program to improve the muscle strength. At 3 months of follow up the patient had almost full range of motion with only a lack of 5 degrees of extension and slight atrophy of biceps and triceps muscles. At final follow up at one year postoperatively there was full range of motion with no pain or instability, and no valgus or varus deformity was observed
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