Posterolateral Elbow Dislocation Research Articles

Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report

IntroductionAcute posterolateral rotator elbow dislocation in a child is rare and can be easily misdiagnosed due to immaturity of the epiphysis. This is the first case of occult posterolateral rotator elbow dislocation in combination with an olecranon fracture. We report our experience with this case, which was not diagnosed correctly by plain radiographs.Case presentationAn 11-year-old Asian boy suffered severe pain and swelling of his right elbow after his outstretched arm hit a car dashboard in a motor vehicle accident. Plain radiographs showed only a minimally displaced olecranon fracture and a tiny lateral epicondylar avulsion fracture. However, stress radiographs under general anesthesia revealed severe posterolateral rotatory instability. During surgery, we found that the cartilaginous lateral epicondylar apophysis was much larger than the epicondylar fragment on the radiographs. After the lateral epicondylar osteochondral fragment and lateral collateral ligament complex were fixed, the instability disappeared.ConclusionOur experience with this case shows that it is important to check for instability with pediatric elbow fractures, because a tiny avulsion fracture was able to cause severe posterolateral rotatory instability in a child.

Triple injury of forearm and elbow—a case report

Fracture of the forearm with ipsilateral dislocation of the elbow is uncommon. Such double injuries are often missed at initial assessment. We report a case of triple injury of forearm and elbow—open elbow dislocation, closed distal radius, and ulna fracture with missed medial epicondyle fracture. To the best of our knowledge, this has not been previously described in literature. The most probable mechanism of injury is a fall on outstretched hand with wrist in dorsiflexion causing the distal radius and ulna fracture with dorsal displacement. Further continuation of the axial compression along with supination of the forearm and valgus at the elbow resulted in posterolateral elbow dislocation and a medial epicondyle avulsion. Early debridement and reduction resulted in satisfactory function. The report attempts to highlight the importance of good clinical and radiological assessment and to understand the mechanism of injury, to rule out other injuries caused by the same mechanism.

IPSILATERAL SIMULTANEOUS SHOULDER AND ELBOW DISLOCATION a case report

Ipsilateral dislocation of the shoulder and elbow joints is a rare and complex injury. Only six patients have been reported in the international literature with ipsilateral dislocation of the shoulder and elbow. Here, we reported a 48 year-old woman who suffered ipsilateral shoulder and elbow dislocation. The patient first presented to a regional hospital and the radiographs taken following the initial evaluation revealed posterolateral dislocation of right elbow. The reduction of the dislocated elbow was performed at that facility. However, since no radiographic examination of the injured shoulder had been carried out, the dislocation injury of the shoulder was missed. Three days later the patient presented to Tepecik Training and Research Hospital emergency Department (Izmir-Turkey), complaining of shoulder pain. Radiographs showed the missed anterior dislocation of right shoulder, which had been reduced under general anaesthesia. At final follow-up, 2.5 years later, the elbow and the shoulder were pain free and had full range of motion. Following a high energy trauma in upper extremities, radiographic examination of the shoulder, elbow and wrists must be performed in case of suspicion.

Displaced medial epicondyle fractures of the humerus: surgical treatment and results. A report of 139 cases

Elbow instability is a common feature after medial epicondyle fractures, displaced or not, even in the absence of dislocation. Undisplaced or minimally displaced fractures often have an underestimated degree of instability secondary to unrecognised capsuloligamentous and muscular injuries. The purpose of this retrospective study was to analyze and to assess objectively the results of the surgical treatment of these acute injuries. One hundred and thirty-nine displaced medial epicondyle fractures were surgically treated and reviewed. A valgus stress test was performed on each child under general anesthesia or sedation. Functional outcome was assessed using a scoring system based on a series of clinical and radiographic criteria. The mean age of patients at the time of accident was 11.9 years. Mean follow-up was 3.9 years. All fractures had associated with instability of the elbow. A posterolateral elbow dislocation was associated in 80 fractures. The medial epicondylar fragment was anatomically reduced and fixed in all cases. The final result was excellent in 130 cases and good in 9 cases. Elbow were stable and pain free in all patients. Normal elbow range of motion was reported in 133 cases. Union was achieved in all cases. Among these cases, nine had presented a <<fibrous>> union with no change on valgus stress views. No cases of cubitus valgus >/=10 degrees were observed. Anatomical abnormalities of the elbow were present in 28 cases: periarticular calcification in 18 cases, medial condyle groove formation in 4 cases, moderate hypertrophy and fragmentation of the medial epicondyle, respectively, in 3 cases. The positive valgus stress test performed at the time of surgery for all epicondyle fractures without associated dislocation regardless of there degree of displacement justified our operative approach. Operative intervention is a good management of these fractures and results in an anatomic reduction, a solid bone union and prevents valgus instability. Even with postoperative immobilization of the elbow (mean of 4 weeks), stiffness is rare. Damage to the medial stabilizing structure of the elbow rather than the extent of medial epicondyle displacement has a far greater influence on joint stability and outcome.

Posterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report

AbstractIntroductionElbow dislocations in children are uncommon injuries. Dislocations with associated fractures or so-called complex dislocations of the elbow can be challenging to diagnose and treat.Case presentationA 14-year-old male had a posterolateral elbow dislocation after a fall. Closed reduction with traction was performed. Radiographs after initial reduction showed a fragment entrapped into the humero-cubital joint. Computerized tomography scan showed the fragment belonging to the medial epicondyle. Open reduction and internal fixation with a 3.0 millimeter cannulated screw was performed, with restoring of the normal function of the elbow at final follow up.ConclusionElbow dislocations in children can be associated with bone lesions. These injuries must be suspected to avoid misleading diagnosis and achieve good results.

Posterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report

IntroductionElbow dislocations in children are uncommon injuries. Dislocations with associated fractures or so-called complex dislocations of the elbow can be challenging to diagnose and treat.Case presentationA 14-year-old male had a posterolateral elbow dislocation after a fall. Closed reduction with traction was performed. Radiographs after initial reduction showed a fragment entrapped into the humero-cubital joint. Computerized tomography scan showed the fragment belonging to the medial epicondyle. Open reduction and internal fixation with a 3.0 millimeter cannulated screw was performed, with restoring of the normal function of the elbow at final follow up.ConclusionElbow dislocations in children can be associated with bone lesions. These injuries must be suspected to avoid misleading diagnosis and achieve good results.

Posterolateral Elbow Dislocation with Ipsilateral Radial and Ulnar Diaphyseal Fractures: A Case Report

Elbow dislocation associated with both ipsilateral radial and ulnar shaft fractures is a rare pattern of injury, although it is common for elbow dislocation and forearm fractures to occur separately. We report a case of an 80-year-old woman who had a posterolateral elbow dislocation and ipsilateral radial and ulnar shaft fractures and underwent closed reduction and plate fixation. She had an excellent outcome after 22 months of follow-up.

Ipsilateral compound distal radius fracture with missed elbow dislocation. A rare injury pattern

A rare injury pattern of compound distal radius fracture associated with a missed posterolateral elbow dislocation in an adult is described. To the best of our knowledge, this has not been previously described in the literature. The probable mechanisms of injury are speculated to include longitudinal compressive force along with valgus and external rotatory stress to the semiflexed elbow leading to elbow dislocation. A continuation of the impact when her hand hit the ground led to her hand deviating radially resulting in compounding on the ulnar side. Early reduction of the dislocation and rigid fixation of the fracture helped to achieve excellent results. We hope that our experience will highlight the need to examine the elbow in severe wrist injuries and to be aware of the possibility of elbow dislocation.

Conservative treatment of posterolateral dislocation of the elbow with medial epicondyle fracture in children between 6 and 8 years old: A report of three cases, literature review

There is great controversy in the existing litera-tureregarding theappropriatetreatmentofsuchaninjury. It has not been made clear whether avulsionof the medial epicondyle associated with a poster-olateral elbow dislocation requires open reductionand internal fixation, or simply a closed reductionand immobilization in a plaster.

Type I Monteggia equivalent injury with posterolateral dislocation of elbow and distal epiphyseal injury—an unusual injury pattern. A case report

We report the case of a 12-year-old boy with an ipsilateral Type 1 Monteggia equivalent fracture with a posterolateral dislocation of the elbow and a Salter Harris Type II distal radius epiphyseal injury. The combination of these three is rare. A literature search has produced a combination of Monteggia fracture either with a posterior dislocation of the elbow or a distal radial epiphyseal injury. Although managed aggressively, this injury pattern had caused restriction of the movement of forearm rotation. This case report is presented because of the rarity of this unusual combination of the injuries and poor outcome with regard to forearm rotation.

Complex Pediatric Elbow Injury: An Uncommon Case

BackgroundThere is paucity of literature describing complex elbow trauma in the pediatric population. We described a case of an uncommon pediatric elbow injury comprised of lateral condyle fracture associated with posterolateral dislocation of elbow.Case presentationA 12-year-old boy sustained a direct elbow trauma and presented with Milch type II lateral condyle fracture associated with posterolateral dislocation of elbow. Elbow dislocation was managed by closed reduction. The elbow stability was assessed under general anaesthesia, followed by open K-wiring for the lateral condylar fracture fixation. The patient had an uneventful recovery with an excellent outcome at 39 months follow-up.ConclusionComplex pediatric elbow injuries are quite unusual to encounter, the management of such fractures can be technically demanding. Concomitant elbow dislocation should be managed by closed reduction followed by open reduction and internal fixation (K-wires or cannulated screws) of the lateral condyle fracture.

POSTEROLATERAL DISLOCATION OF THE ELBOW WITH CONCOMITANT FRACTURE OF THE LATERAL HUMERAL CONDYLE

We describe a case of a 6-year-old girl with a posterolateral elbow dislocation and a concomitant fracture of the lateral humeral condyle. After reduction of the dislocation, the fracture was diagnosed and treated by open reduction and fixation, with a good functional result. In doubtful cases, oblique, heterolateral, and varus stress films, or even arthrography may be necessary.

CHRONIC POSTEROLATERAL DISLOCATION OF THE ELBOW IN A CHILD

CHRONIC POSTEROLATERAL DISLOCATION OF THE ELBOW IN A CHILD

The Ulnar Collateral Ligament is Always Torn in the Posterolateral Elbow Dislocation: A Suggestion on the new Mechanism of Dislocation Using MRI Findings

PURPOSE: From the status of ulnar collateral ligament of elbow with magnetic resonance image which suffered with posterolateral dislocation. We would propose the novel mechanism of posterolateral elbow dislocation.MATERIALS AND METHODS: Between November 2005 and October 2009, we prospectively collected 12 cases of simple posterolateral elbow dislocation. The location of bone contusion and the status of collateral ligament were evaluated with MRI. Collateral ligament was divided in 2 subgroups (distraction type, stripping type). We also defined the disengagement as escaping of conoid process from trochlear notch totally.RESULTS: From 12 cases, we could found 11 cases of bone contusion in radial head or capitellum. Trochlea and conoid process were always intact without bone contusion. All ulnar collateral ligament ruptures were distraction type instead of all lateral collateral ligament ruptures were stripping type. Translations of all cases were shown those of the ulnar collateral ligament were longer than those of lateral collateral ligament (p&lt;0.05).CONCLUSION: We carefully conclude that UCL and surrounding soft tissue has responsibility for the initiation of simple posterolateral elbow dislocation.