Management of Neglected Elbow Dislocations in a Setting with Low Clinical Resources

Abstract

Operative treatment of late-presenting, unreduced elbow dislocation is effective in restoring the joint to a painless, stable and functional limb.

Functional outcomes following surgical treatment of chronically unreduced simple elbow dislocations: a retrospective review

“…The majority of acute elbow dislocations (80-90%) are posterior or postero-lateral and result from a fall on outstretched hand with the forearm pronated. 2,4,7,8 Other mechanisms of injury include high velocity motor vehicle accidents, assaults and sports-related injuries. Lateral, posterior medial, medial, anterior and divergent (characterised by displacement of the radius from the ulna) are much less common.…”

“…Despite the frequency of acute elbow dislocations, chronic elbow dislocations are rare. 1,2 Patients with chronic elbow dislocations are frequently the result of their not seeking treatment after the initial injury, poor access to health care, inadequate initial treatment of acute dislocation or initial missed diagnosis. [1][2][3] Neglected (chronic) elbow dislocations are defined as dislocations left unreduced for more than two weeks.…”

“…1,2 Patients with chronic elbow dislocations are frequently the result of their not seeking treatment after the initial injury, poor access to health care, inadequate initial treatment of acute dislocation or initial missed diagnosis. [1][2][3] Neglected (chronic) elbow dislocations are defined as dislocations left unreduced for more than two weeks. [1][2][3][4] These injuries are uncommon in developed countries, 5 but more frequently encountered in developing countries.…”

“…[1][2][3] Neglected (chronic) elbow dislocations are defined as dislocations left unreduced for more than two weeks. [1][2][3][4] These injuries are uncommon in developed countries, 5 but more frequently encountered in developing countries. 3,6 Dislocations without concomitant fractures are termed 'simple dislocations' while dislocations that are associated with fractures of the coronoid process, radial head or neck, distal humerus or olecranon are termed 'complex dislocations'.…”

“…3,6 Dislocations without concomitant fractures are termed 'simple dislocations' while dislocations that are associated with fractures of the coronoid process, radial head or neck, distal humerus or olecranon are termed 'complex dislocations'. 2 Patients with chronic elbow dislocations present with disability as a result of a fixed position or decreased range of motion (ROM). Many of these individuals are of an economically active age group and in many instances are the only breadwinners in the family.…”