Posterior approach for surgical treatment of neglected elbow dislocation
Introduction: Neglected elbow dislocations often result in contracture and functional impairment.
Surgical treatment is challenging because of the accompanying triceps retraction. We
wanted to share our experience in treating these neglected dislocations using the posterior
Patients and methods: This was a consecutive, prospective study over a 4.5-year period (January
2003 to June 2007) that included all the patients who presented with a neglected elbow
dislocation that was older than 21 days. We treated 22 patients (17 men, five women) with an
average age of 22.8
8.2 years (range 14 to 46 years). The dislocations were 8.5
old on average (range 2 to 17 months). Average elbow flexion was 46.0? ±
25.9? (10? to 90?) and
the extension deficit was 19.5? ±
18.4? (0? to 60?) before the surgery. A paratricipital approach
was used in all patients. In 14 patients, the dislocation was reduced without triceps lengthening.
In eight patients, a V-Y plasty of the triceps muscle was required.
Results: The average follow-up was 21 months (range 12 to 30 months). The improvement in the
overall range of motion was statistically significant. Average elbow flexion was 112.7? ±
(60? to 130?) and the extension deficit was 26.6? ±
17.0? (0? to 60?). The average Mayo Clinic
Elbow Performance Index score was 86 (range 50 to 100), with 14 excellent, four good, two
average and two poor results. Complications included three cases of ulnar nerve paresis, which
subsided within three months, and one case of superficial infection.
Discussion: Although surgical treatment is challenging, the functional improvement in
neglected elbow dislocations is outstanding. The best functional results can be expected when
the triceps splitting approach to the elbow is not used.
Auteur(s) : N.F. Coulibaly, H. Tiemdjo, A.D. Sane, Y.F. Sarr, A. Ndiaye, S. Seye
Pages : 552—558
Année de publication : 2012
Revue : Orthopaedics & Traumatology: Surgery & Research
N° de volume : 98
Type : Article
Mise en ligne par : COULIBALY Ndèye Fatou