Early Joint Use Following Elbow Dislocation Limits Range-of-Motion Loss and Tissue Pathology in Posttraumatic Joint Contracture

Simple acute postero-lateral elbow dislocation: A historical perspective

PURPOSE

The aims of this study were to summarize (1) the historical knowledge of the posterolateral elbow dislocation (PLED) pattern and the biomechanical, radiographic, and clinical data that engendered its evolution; and (2) to help clinicians better understand the management of PLED.

METHODS

A literature search was performed using Ovid, Scopus and Cochrane Library, and the Medical Subject Headings vocabulary. Results are discussed as a chronologic review of the relevant literature between 1920-2022.

RESULTS

In 1966 Osborn and Cotterill were the first to describe posterolateral rotatory instability (PLRI) causing the PLED. Several theories on PLED were then published by others surgeons as our understanding of elbow biomechanics continued to improve. Multiple treatment protocols have been designed based on the aforementioned theories. Conservative and surgical treatment for PLED provides excellent functional outcomes. However, high rates of persistent pain stiffness and instability have been reported long-term, and no single approach to treatment has been widely accepted.

CONCLUSION

Despite a growing body of biomechanical evidence, there is no consensus surgical indication for the treatment of PLED. Both conservative and surgical management result in satisfactory functional outcomes after PLED. However, elevated rates of residual pain, and instability have also been described and may limit heavy labor and sports participation. The next challenge for elbow surgeons will be to identify those patients who would benefit from surgical stabilization following PLED.

Neglected Elbow Dislocation leading to Ankylosis of Elbow: A Case Report

Introduction

Neglected elbow dislocation is defined as a dislocation that is present for 3 weeks or longer. There is no available literature on neglected elbow dislocations, leading to ankylosis of the elbow joint.

Case Report

A 17-year-old female sustained a road traffic accident. Anteroposterior and lateral view radiographs of the forearm were done and deemed to be normal at another hospital. Six months after the injury, she presented to us with complaints of absent elbow movements. Examination revealed the elbow to be fixed in 30° of flexion. Radiographs of the elbow revealed an ankylosis of the ulnohumeral articulation in an abnormal position.

Conclusion

This case demonstrates that neglected elbow dislocations can lead to ankylosis of the joint. It also shows how radiographs of the forearm are inadequate to assess for elbow dislocations even if the elbow region is covered in the radiograph.