Results of posterior dislocation of elbow associated with bony and soft tissue injury.

Neel M Bhavsar,Jigar B Chhapan,Jyotish G Patel,Pankaj R Patel

doi:10.5704/moj.1303.010

Abstract

Elbow trauma is challenging to manage by virtue of its complex articular structure and capsuloligamentous and musculotendinous arrangements. We included 17 patients with elbow dislocation and associated injuries in this study. The study protocol included early elbow reduction and planned fixation of the medial or lateral condyle, coronoid and radial head. The sample was 73% male and 27% female with mean duration follow-up of 8 months, and mean age of 37 years. The mean Mayo Elbow Performance Score was 96 points at conclusion of follow-up, indicating an excellent result in 14 patients. Whenever the radial head was excised, we performed a strong transosseous ligamentous repair of the medial and lateral collateral ligaments. Fixation of the coronoid is essential for elbow stability. A small avulsed fragment can be fixed using an ACL jig. We found this technique very useful. Early planned intervention, stable fixation, and repair provide sufficient stability and enhance functional outcomes. elbow dislocation, ligament instability, coronoid fracture.

Highlights

Trauma to the elbow can be challenging to treat by virtue of the complex articular structure as well as capsuloligamentous and musculotendinous arrangements
Improved understanding of elbow injuries has led to rapid evolution of treatment concepts. This elbow injury pattern is frequently associated with the disruption of the lateral band of the ulnar collateral ligament, as it is the first structure to be disrupted in the Horti circle of soft tissue disruption of the elbow, which refers to the three consecutive stages of lateral to medial progression of elbow dislocation[1,2]
The lateral band of the ulnar collateral ligament, disrupted in the first stage, is critical to elbow stability and its reconstruction may be crucial in the restoration of the joint[3]

Summary

INTRODUCTION

Trauma to the elbow can be challenging to treat by virtue of the complex articular structure as well as capsuloligamentous and musculotendinous arrangements. Improved understanding of elbow injuries has led to rapid evolution of treatment concepts. This elbow injury pattern is frequently associated with the disruption of the lateral band of the ulnar collateral ligament, as it is the first structure to be disrupted in the Horti circle of soft tissue disruption of the elbow, which refers to the three consecutive stages of lateral to medial progression of elbow dislocation[1,2]. Speaking, a type I fracture of the coronoid involving just the tip is not a substantial insult to elbow stability, but a type II injury or worse significantly increases elbow instability[3]. We present a retrospective study of patients with elbow instability

MATERIALS AND METHODS

RESULTS

DISCUSSION

F LCL MCL damage

CONCLUSION