Divergent Dislocation Of Elbow Research Articles

Repair of a Divergent Elbow Dislocation with Distal Ulnar Fracture in a Dog Using TightRope and External Skeletal Fixation

AbstractThe aim of this study was to report the outcome in a 6-year-old male English Setter dog that suffered a combination of divergent elbow dislocation and open distal ulnar fracture. This study is a case report. After surgical reduction in the elbow luxation, the dog was treated with the TightRope fixation system used as replacement of the lateral collateral ligament, a radioulnar positional screw, and external skeletal fixation. Removal of all implants was performed 3 months postoperatively. The 6-month follow-up visit found the dog without lameness, displaying normal activity, and with normal elbow range of motion and normal Campbell's test. Successful surgical management was achieved with good long-term results using TightRope, a positional screw, and an external skeletal fixator.

Diagnosis and treatment of bipolar fracture-dislocation of the forearm

Objective To investigate diagnosis and surgical treatment of bipolar fracture-dislocation of the forearm. Methods A retrospective study was conducted of 16 patients with forearm bipolar fracture-dislocation who had been treated and completely followed up at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from March 2011 to September 2017. They were 14 males and 2 females, aged from 17 to 48 years (average, 35.8 years). Their injury involved 7 left and 9 right sides, and 10 dominant and 6 non-dominant sides as well. Their proximal injury was divergent elbow dislocation in 4 cases, convergent elbow dislocation in one case, Monteggia fracture-dislocation in 9 cases (2 ones of type I, 2 ones of type ⅡB, 4 ones of type ⅡC and one of type Ⅳ), and upper radioulnar dislocation in 2 cases. Their distal injury was distal radial fracture (intra-articular)+lower radioulnar dislocation in 7 cases, distal radioulnar fracture+lower radioulnar dislocation in 2 cases, Galeazzi fracture (1/3 distal humeral shaft) in 3 cases, and middle and upper middle radial fracture+lower radioulnar dislocation in 4 cases. Open reduction and internal fixation was performed for all the shaft fractures and most of the distal radial fractures. One distal radius fracture was treated with closed reduction and external fixation, one case with external fixation, one case with needle insertion and external fixation, 3 radial head fractures with internal fixation, 3 cases with radial head replacement, 2 cases untreated, 5 cases with open ligament repair because their primary closed reduction failed, and 2 cases with hinged external fixation of the elbow. Their functional exercise started according to judgment of joint stability after surgery. At the last follow-up, the overall function of the forearm was evaluated according to the Anderson＇s scoring. Results The 16 patients were followed up for an average of 26.0 months (from 6 to 60 months). All fractures healed at the internal fixation sites after operation with no abnormality affecting the function. No infection occurred. All the elbow joints and upper and lower radioulnar joints were stable. All the radial head replacements were in good position. The range of elbow flexion and extension averaged 123.2° (from 60° to 140°), the range of wrist flexion and extension 150.3° (from 120° to 160°), and the rotational mobility of the forearm 144.4° (from 70° to 170°). At the last follow-up, according to the Anderson's scores, 11 cases were rated as excellent, 3 cases as satisfactory, one case as unsatisfactory and one case as failure. Conclusions Most of the forearm bipolar fractures and dislocations are high-energy injury. The key to treatment is to achieve good reduction of distal and proximal dislocations and to start rehabilitative exercise as early as possible. Intraoperative fixation of fractures should be based on stable reduction of the dislocation. Fine reduction of bipolar dislocations and early rehabilitation can lead to good functional recovery. Key words: Forearm injuries; Dislocations; Fractures, bone; Diagnosis; High energy injury

A case report of divergent elbow dislocation of a child during school sports drill

Divergent dislocation of elbow is a rare injury with few reports or short series. These dislocations require prompt diagnosis with careful evaluation of radiographs and emergent reduction and splinting. Axial force overflexed or semi-flexed elbow may be initial mechanism that dislocates the elbow and propagation of force then separates radius and ulna as in our case. Injury in school drills are usually minor, but complex dislocation may occur in events involving somersault and backflips requiring caution for the prevention and urgent management. We, hereby, describe relevant details of transverse divergent elbow dislocation in a 10-year-old child with appropriate management leading to uneventful recovery and satisfactory functional outcome.

Open Anterior Transverse (Divergent) Dislocation of the Elbow Joint

Kassé, Amadou Ndiassé MD1; Diallo, Malick MD1; Sané, Jean Claude MD1; Thiam, Babacar MD1; Bousso, Abdoulaye MD1; Sy, Mouhamadou Habib MD; Prof1Author Information

Convergent and divergent dislocation of the pediatric elbow

Convergent and divergent pediatric elbow dislocations are rare injuries. When properly diagnosed and treated without delay, both types of dislocations have a good prognosis. We describe a case of convergent elbow dislocation in a 16-year-old boy. The patient underwent operative intervention and demonstrated full range of motion at the 4-year follow-up. Our second case describes an 11-year-old boy with a divergent elbow dislocation associated with an ipsilateral distal radius fracture and distal radioulnar joint dislocation. The patient showed full range of motion 1 year after closed reduction and casting and had no residual deformities or abnormalties.

Divergent elbow dislocation with radial shaft fracture, distal ulnar deformation, and distal radioulnar joint instability: an unclassifiable Monteggia variant

Originally described by Monteggia and later classified by Bado, elbow dislocations with concurrent radial and ulnar shaft fractures with distal radioulnar joint (DRUJ) disruption are considered operative cases with high-energy injurious etiologies. Here, we present an unclassifiable Monteggia variant fracture suffered through a high axial load mechanism in a 47-year-old female. The fracture pattern initially exhibited included a divergent elbow dislocation, a radial shaft fracture, plastic deformation of the distal ulna, and DRUJ instability. Here we describe the pattern in detail, along with definitive treatment and clinical outcome at 1 year follow-up.

Traumatic Divergent Elbow Dislocation in an Adult with an Associated Fracture of the Distal Part of the Humeral Shaft and an Open Perilunate Dislocation: A Case Report.

Divergent dislocation of the elbow represents an extremely rare injury. The proximal radioulnar joint is disrupted as the distal part of the humerus is driven between the radius and ulna, and the forearm dislocates posteriorly. We believe that DeLee, in 1981, reported the first modern case of divergent elbow dislocation that was confirmed by radiographs in a child1. Subsequently, to the best of our knowledge, there have been twenty-one additional reported cases of divergent elbow dislocation in children2-19. We identified only one previously published case report of traumatic divergent elbow dislocation in an adult20. We present an adult patient with a traumatic divergent dislocation of the elbow with an associated humeral fracture and an open perilunate dislocation. The patient was informed that data concerning the case would be submitted for publication, and he provided consent; the institutional review board approved the submission. ### Initial Patient Presentation A twenty-nine-year-old right-hand-dominant man presented to our emergency department after landing on the outstretched left upper extremity following a 15-foot fall from a ladder. Initial physical examination of the extremity revealed gross deformity of the midhumerus and swelling of the left elbow. A 2-cm wound over the lateral part of the elbow communicated with the radiocapitellar joint. Carpal bones were extruded through a second wound over the volar aspect of the wrist on the same extremity. The patient’s hand was well-perfused with palpable pulses. He reported paresthesias in the median nerve distribution. Radiographs demonstrated a displaced mid-diaphyseal humeral fracture and an open divergent elbow dislocation (Figs. 1-A and 1-B). Distally, the patient had an open trans-scaphoid perilunate dislocation, fracture of the trapezium, and left fourth and fifth metacarpal fractures (Figs. 2-A and 2-B). Additional injuries included fractures of the lumbar transverse processes, ribs, superior and inferior pubic rami, iliac wing, …

Divergent Elbow Dislocation in the Very Young Child: Easily Treated If Correctly Diagnosed

We report a case of a 3-year-old boy that sustained a divergent elbow dislocation and was treated appropriately once the diagnosis was established. The purpose of this report is to bring attention to this rare injury.

Transverse divergent dislocation of the elbow in adult: a 9-year follow-up

Transverse divergent dislocation of the elbow, in which the radius and ulna dislocate in diverging directions, is an extremely rare injury (19 cases have been reported in the literature). Usually, this type of elbow dislocation occurs in children, and an adult case is extremely rare. In this report, we present a case of a transverse divergent dislocation of elbow in a 20-year-old woman, treated with conservative method and long-arm cast immobilization. At 9 years, she had no pain in the elbow, returned to full activities and had normal function. The X-ray of the elbow was normal, except for a small nonunited bony fragment adjacent to the coronoid process of the ulna.

Divergent Dislocation of Elbow with Ipsilateral Distal Radioulnar Joint Dislocation in a Gymnast

Divergent dislocation of the elbow is a rare injury. It is a result of longitudinal disruption of interosseous membrane of forearm. Although it can logically result in disruption of distal radioulnar joint, according to the authors’ knowledge this combination has not been reported before. The case of a young gymnast is presented who suffered this injury. She was treated successfully in a hinged external fixator and with stabilization of distal radioulnar joint by a K-wire. She regained almost full range of movement and returned to national level gymnastics.

Divergent dislocation of elbow with ipsilateral fracture in both forearm bones in a child

The transverse divergent dislocation of elbow in children is a rare occurrence. Case of a 12-year-old girl is presented who sustained this injury along with circulatory compromise and ipsilateral fracture of distal radius and ulna. An early closed manipulation of the elbow restored joint and circulatory function. The distal radius fracture required open reduction and K wiring for optimum reduction and stability.

Divergent Dislocation of elbow with Ipsilateral CollesFracture: Report of One Case

Divergent Dislocation of elbow with Ipsilateral CollesFracture: Report of One Case

Divergent Pediatric Elbow Dislocation

A six-year-old boy with divergent elbow dislocation is reported, emphasizing the rarity of this condition. A literature review revealed only three roentgenographically documented divergent elbow dislocations in the pediatric age group. Reduction is usually accomplished with ease; however, a full range of elbow motion and forearm rotation must be obtained to ensure complete reduction of the radiohumeral joint.