Side swipe injury elbow with fixed object collision in mountain region: Presentation and management

Abstract

Introduction: Side swipe injury is a subgroup of complex elbow trauma. Management of such injury is a formidable challenge to the orthopaedic surgeon. There is no fixed management protocol that is followed due to different presentation which results in poor functional outcome. We have presented a series of rarely reported side swipe injury elbow with fixed object collision in mountain region. Material and method: A prospective study of elbow trauma of eight patient sustaining sideswipe injuries to the upper limb. Seven patients were male and one was female. Mean age was with a range of 24 to 45 years. Five were left sided non dominant and three were right dominant limb. In six patient’s injury were confined to limb and among rest two who were sustained associated injuries. One patients required immediate vascular repair followed by debridement, external fixation than definitive fixation. One patient was unusually presented with open fracture humerus with brachial plexus injury and 3 patients required external fixation, open reduction and internal fixation for open fractures of the humerus, ulna and radius. Internal fixation was used in 3 patients as primary stabilization. Complications and outcome were recorded in follow-up at outpatient department up to 1 year. Results were evaluated using the Mayo elbow performance score. Results: The injury severity scores ranged from 9 to 22. The average Mayo elbow performance score was 47.5. Good results (score 75-89) was seen in 12.5% patient. Fair (60-74) and poor results (Less than 60) were seen in 25% and 62.5% patients respectively. Conclusions: Initial assessment and staged protocol management may be needed to achieve functional result in side swipe elbow injury with fixed object in mountain region which can be presented from mild to complete loss of limb function.