Unusual case of complex fracture dislocation of the elbow

Rebeca Díaz Suárez1 · Gonzalo Luengo Alonso1 · Miguel Ángel Porras Moreno1,2 · Verónica Jiménez Díaz1,2,3 · Lorena García Lamas1,2 · Navidad Cecilia López1,2,3

Received: 30 July 2018 / Accepted: 1 November 2018 © The Author(s) 2018

Unusual case of complex fracture dislocation of the elbow

Introduction

In terms of major joints, the elbow is the second most frequently dislocated joint in adults (7.3%). Only shoulder dislocation is more common (50.6%) [1]. It represents up to 3–6% of elbow injuries in children and is the most commonly dislocated joint among this group [2]. Up to 10–20% of injuries affecting the elbow are dislocations: They are classified as simple or complex, based on the presence of a fracture [3].

This injury frequently occurs during sporting activities, patient falling onto an extended hand with the elbow in extension and abduction. However, elbow fracture dislocation may occur in distinct patterns.

Complex dislocations are related to a high number of complications, including recurrent instability, arthrosis, stiffness, infection, nerve and vascular injury, compartment syndrome and heterotopic ossification [3].

The most frequent complication related to this injury is extension loss; early mobilization can prevent this from happening, obtaining a good and functional range of motion (ROM). It is important to bear in mind: Most daily activities can be performed with a 30–130 degrees ROM [4].

Up to 20% of elbow dislocations are complex, requiring surgical treatment to achieve proper stability and a good outcome [4, 5] First of all, closed reduction should be performed in the emergency department, followed by open reduction and internal fixation [6]. The main objective treating elbow fracture dislocations is to achieve stability so patients start therapy as soon as possible. With early therapy, we are trying to avoid stiffness.

We are reporting a very rare case of complex elbow dislocation, involving ulnar diaphysis, coronoid process and radial head fractures.

Read full article here

Leave a Reply