Chronic Unreduced Elbow Dislocation Treated with Hinged External Fixator and Transarticular Pin Fixation

Jung Yun Bae; Tae Woo Kim; Sang Ho Kwak; Kuen Tak Suh

doi:10.4055/jkoa.2016.51.6.521

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Bae, Kim, Kwak, and Suh: Chronic Unreduced Elbow Dislocation Treated with Hinged External Fixator and Transarticular Pin Fixation

Case Report

Journal of the Korean Orthopaedic Association 2016; 51(6): 521-526.

Published online: 30 December 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.6.521

Chronic Unreduced Elbow Dislocation Treated with Hinged External Fixator and Transarticular Pin Fixation

Jung Yun Bae, M.D., Tae Woo Kim, M.D., Sang Ho Kwak, M.D., Kuen Tak Suh, M.D., Ph.D.

Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.

Correspondence to: Sang Ho Kwak, M.D. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. TEL: +82-55-360-2155, FAX: +82-55-360-2503, shkwak2013@gmail.com

Received 28 January 2016 Revised 20 June 2016 Accepted 24 July 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronically unreduced elbow dislocation has commonly been described in underdeveloped countries. This is a very rare type of injury, and only two cases have been reported in Korea. Due to the potentially conflicting goals of restoring elbow stability and satisfactory function, successful treatment is a challenge even for experienced trauma surgeons. Herein, we described two cases of chronically unreduced elbow dislocation treated with open reduction and additional bony fixation using hinged external fixator and transarticular pin fixation.

Keywords: joint instability, dislocations, elbow, external fixators

Figures and Tables

Figure 1

Lateral and anteroposterior radiographs of a 58-year-old woman with unreduced posterior dislocation of the left elbow six weeks after the original injury.

Figure 2

Immediate postoperative radiographs of open reduction is shown.

Figure 3

Lateral and anteroposterior radiographs, made three days after the initial surgery. The elbow was dislocated again.

Figure 4

(A) The hinged external fixator was composed of a hinge and two radiolucent bars. (B, C) Transarticular Steinmann pin fixation and hinged external fixator was applied after the second open reduction.

Figure 5

(A, B) At 12 months after the surgery, there was no arthritic change. Note the heterotopic ossification around the coronoid process. (C) Near full range of motion was obtained compared with the right elbow.

Figure 6

(A, B) Lateral and anteroposterior radiographs of a 49-year-old male demonstrating unreduced posterior elbow dislocation 4 months after the initial injury. (C) A sagittal section of computed tomography revealed an intact coronoid process. (D–G) Radiographs of immediate postoperative state and a 12-month postoperative state showed that concentric joint space was maintained without further progression of arthritic change.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

References

1. King GJW. The complex dislocations of the elbow. In : Celli A, Celli L, Morrey BF, editors. Treatment of elbow lesions. New York: Springer;2008. p. 103–112.

2. Morrey BF. Chronic unreduced elbow dislocation. In : Morrey BF, editor. The elbow and its disorders. 3rd ed. Philadelphia: WB Saunders;2000. p. 431–436.

3. Oh IS, Bahk KJ. Old unreduced posteromedial dislocation of elbow joint: a case report. J Korean Orthop Assoc. 1993; 28:637–640.

4. Kim BK, Kim KC, Park JY, Shin HD. Neglected elbow dislocation occurred 3 years ago: open reduction and hinged external fixation: a case report. Clin Should Elbow. 2010; 13:266–269.

5. Lo CY, Chang YP. Neglected elbow dislocation in a young man: treatment by open reduction and elbow fixator. J Shoulder Elbow Surg. 2004; 13:101–104.

6. Mehta S, Sud A, Tiwari A, Kapoor SK. Open reduction for late-presenting posterior dislocation of the elbow. J Orthop Surg (Hong Kong). 2007; 15:15–21.

7. Billett DM. Unreduced posterior dislocation of the elbow. J Trauma. 1979; 19:186–188.

8. Vangorder GW. Surgical approach in old posterior dislocation of the elbow. J Bone Joint Surg. 1932; 14:127–143.

9. Naidoo KS. Unreduced posterior dislocations of the elbow. J Bone Joint Surg Br. 1982; 64:603–606.

10. Arafiles RP. Neglected posterior dislocation of the elbow. A reconstruction operation. J Bone Joint Surg Br. 1987; 69:199–202.

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