Surgical treatment for the fractures and dislocations of the elbow in old patients

Abstract

To introduce and report the preliminary results of 7 old patients with fractures and dislocations of the elbow. From July 2011 to August 2015, 7 old patients suffered from fractures and dislocations of the elbow(5 of which were terrible triad). One patient had type Iradial head fracture, 3 type IIand 1 type III according to the Mason classification, and 1 type I, 5 type IIand 1 type III according to the Regan-Morrey classification. All the 7 patients received operation and then were treated with external fixation. Fractures of the radial head were fixed with Herbert screws or locking plates and screws. Fractures of ulnar coronoid were reduced and fixed with lag screws or K-wires or PDS sutures or locking screws according to the types. The lateral and medial collateral ligaments were also repaired. Plaster external fixation was applied for 3 weeks after operation, in the position with elbow flexion in 90 degrees and forearm rotation in neutral. External fixation braces were used for each patient after the plasters were removed, and at the same time rehabilitation programs were carried out. All the 7 patients were followed up, and the during ranged from 13 to 48 months(averaged, 20 months), with healed fractures, stable elbow and no pain movement. The functional outcome was excellent in 3 patients, good in 3 and fair in 1 according to the Mayo Elbow Performance Score(MEPS). It is not easy to get stable fixation for fractures and dislocations of the elbow in old patients with osteoporosis and low density of bone, but the operation can achieve satisfied clinical outcomes after external fixation.