Abstract
Dislocation of the elbow joint is the second most common dislocation after the shoulder joint. Although this pathology is relatively common, concomitant vascular injuries are rare. We present a case of a patient who sustained a fall on his arm with an outstretched elbow that resulted in a closed simple posterolateral elbow dislocation and delayed thrombosis of the brachial artery followed by two revascularisation surgeries. The physician must always maintain a high index of suspicion for a concomitant vascular injury before and after closed reduction of the elbow joint and have in mind that complete ischemia without any pulsations could be absent because the elbow is surrounded by rich collateral anastomoses. Suspicion should be even stronger in the presence of bony lesions or open injuries. A team of trauma and vascular surgeons has to work hand in hand as surgical treatment with a saphenous graft or direct suture is the first method of choice with the prior requirement of a stable elbow joint.
Highlights
A dislocation of the elbow joint is the second most common dislocation after the shoulder joint withPovilas Masionis, Rokas Bobina, Valentinas Uvarovas, Narūnas Porvaneckas, Igoris Šatkauskas dislocations and only up to 0.5% in simple closed dislocations [3, 5,6,7,8,9,10]
In the most cases, an arterial injury is present at the time of dislocation, but presentation can be delayed from the time when the patient is discharged from the hospital to ten days after closed reduction [5]
The most likely cause could be explained by the anatomy of the cubital fossa: during a posterior elbow dislocation, the distal portion of the brachial artery is trapped between the rigid biceps aponeurosis and the distal humerus [2]
Summary
A dislocation of the elbow joint is the second most common dislocation after the shoulder joint withPovilas Masionis, Rokas Bobina, Valentinas Uvarovas, Narūnas Porvaneckas, Igoris Šatkauskas dislocations (associated with bony lesions) and only up to 0.5% in simple closed dislocations [3, 5,6,7,8,9,10]. There were no signs of neurovascular damage: pulsations of radial and ulnar arteries, motions of fingers, and sensations were normal. Clinical examination revealed a stable right elbow joint, haematoma in the antecubital fossa, absence of pulsations of radial and ulnar arteries, and a decreased capillary refill in fingers.
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