scholarly journals Open reduction of an old and unreduced posterior elbow dislocation

2021 ◽  
Vol 6 (2) ◽  
pp. 166-169
Author(s):  
Tudor Mihai Gavrilă ◽  
◽  
Emanuel Antoneac ◽  
Cristea Vlad ◽  
Stefan Cristea
Keyword(s):  
Open Reduction ◽  
Elbow Dislocation ◽  
Coronoid Process ◽  
Joint Surface ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Cast Immobilization ◽  
Anterior Capsule ◽  
Stiff Joint

The old unreduced elbow dislocation is not very frequent, but when it is found, it is a challenge for every surgeon. We present a case of 65 years old man who came to the hospital with a dislocated elbow. After the first attempt to reduce, the elbow was mobilized in sling for 2 weeks, but during a small effort, the joint dislocated again. Another two orthopedic reduction were tried, followed by cast immobilization, but the elbow dislocated again. The patient presented in our service after two months from the injury with stiff joint in a vicious position. On imagistic examinations (Rx, CT, MRI), it was found comminuted fracture of coronoid process, posterior dislocation of olecranon and both collateral ligaments were torn. An open reduction was performed during which the joint surface was cleaned up, the anterior capsule was reattached to the coronoid process with an anchor, and then, collateral ligament was restored with the help of autograft, a gracilis muscle (bone fixed with two anchors). Postoperatively, the patient slowly began to mobilize the elbow with splint protection. After a year, the patient returned for follow-up; the function was completely restored and he had no pain.

scholarly journals Repair of a Divergent Elbow Dislocation with Distal Ulnar Fracture in a Dog Using TightRope and External Skeletal Fixation

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e58-e64
Author(s):  
Marcos Garcia ◽  
Camille Bismuth ◽  
Claire Deroy-Bordenave
Keyword(s):  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Normal Activity ◽  
Long Term Results ◽  
Collateral Ligament ◽  
Elbow Luxation ◽  
Ulnar Fracture ◽  
Fixation System

AbstractThe aim of this study was to report the outcome in a 6-year-old male English Setter dog that suffered a combination of divergent elbow dislocation and open distal ulnar fracture. This study is a case report. After surgical reduction in the elbow luxation, the dog was treated with the TightRope fixation system used as replacement of the lateral collateral ligament, a radioulnar positional screw, and external skeletal fixation. Removal of all implants was performed 3 months postoperatively. The 6-month follow-up visit found the dog without lameness, displaying normal activity, and with normal elbow range of motion and normal Campbell's test. Successful surgical management was achieved with good long-term results using TightRope, a positional screw, and an external skeletal fixator.

Elbow Dislocation and Articular Fracture of the Distal Humerus

2010 ◽  
Vol 2 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Thierry G. Guitton ◽  
Andrew D. Duckworth ◽  
Margaret M. Mcqueen ◽  
Peter Kloen ◽  
David Ring
Keyword(s):  
Medial Collateral Ligament ◽  
Articular Surface ◽  
Present Report ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Collateral Ligament ◽  
Articular Fracture

Background The present report describes subluxation and dislocation of the elbow with articular fracture of the distal humerus and injury to the medial collateral ligament, a type of elbow fracture-dislocation about which little is available in the literature. Methods Twenty-two patients with subluxation or dislocation of the elbow (with injury to the medial collateral ligament) and a fracture of the distal humerus articular surface (capitellum/trochlea) were identified. Seventeen patients had a minimum of 12 months follow-up and eight patients returned for a long-term follow-up at a median of 36 months (range 12 months to 154 months) after injury. Results Nine patients had one or more subsequent surgeries. Seven patients had surgery to address complications and two had a planned implant removal. The final median arc of elbow flexion was 120° (range 100° to 145°) and the median arc of forearm rotation was 175° (range 150° to 180°). The median Broberg and Morrey score was 88 points (range 63 points to 100 points) and the median Disabilities of the Arm Shoulder and Hand score was 9 points (range 1 point to 43 points). Discussion Some elbow dislocations and subluxations are associated with osteochondral fractures of the distal humeral articular surface.

scholarly journals Lesión compleja del codo pediátrico: fractura de cóndilo externo asociada a luxación posteromedial de codo.

2020 ◽  
pp. 56-60
Author(s):  
A DARAS-BALLESTER ◽  
NADIA JOVER-JORGE ◽  
PEDRO DOMENECH-FERNANDEZ
Keyword(s):  
Open Reduction ◽  
Elbow Dislocation ◽  
Complex Case ◽  
Long Term Results ◽  
K Wires ◽  
Condyle Fracture ◽  
Clinical And Radiological Results ◽  
Humeral Condyle

Background and aim: External humeral condyle fracture associated with a posteromedial elbow dislocation is a very rare entity, of which there are very few cases published. Our objective is to present a complex case treated in our Hospital, the diagnosis, the treatment we chose, and the follow-up at 9 weeks after the intervention. Clinical case: 5-year-old boy with a posteromedial elbow dislocation associated with an external humeral condyle fracture, which was diagnosed by CT and treated surgically using an anterior approach over the elbow, open reduction, and osteosynthesis with K-wires. Results: clinical and radiological results 9 weeks after the intervention were excellent, presenting a Radiographic consolidation of the fracture and an excellent range of joint mobility. Conclusion: early diagnosis and surgical treatment through open reduction and osteosynthesis of the external condyle is the gold standard on treatment for these injuries, since a bad reduction leads to poor long-term results.

scholarly journals Anterior elbow dislocation without fracture in an adult: a rare injury pattern

2019 ◽  
Vol 12 (9) ◽  
pp. e230115 ◽  
Author(s):  
Sandeep Vijayan ◽  
Vijayaraghavan Chalappurath ◽  
Sudeep Jose ◽  
Sharath Kumar Rao
Keyword(s):  
Elbow Dislocation ◽  
Functional Results ◽  
Ligament Injury ◽  
Anterior Dislocation ◽  
Joint Stability ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Rare Injury ◽  
Elbow Injury ◽  
Medial Collateral Ligament Injury

Anterior elbow dislocation without periarticular fracture (simple dislocation) is an extremely rare injury and is usually caused by distraction or torsional forces. It is important to look for associated ligamentous and musculotendinous injuries in this pattern. We report an elderly patient who sustained simple anterior dislocation of the elbow and in whom successful closed reduction could be achieved. Reduction by closed method is possible if we know the exact mechanism of elbow injury. Despite the presence of medial collateral ligament injury, he was managed non-operatively and had full functional recovery. Checking for joint stability and collateral ligaments after reduction and getting additional radiological investigations help in better treatment planning. Early protected active mobilisation should be initiated to achieve better functional results.

The Treatment of Chronic Flexion Contractures of the Proximal Interphalangeal Joint

1995 ◽  
Vol 20 (3) ◽  
pp. 385-389 ◽  
Author(s):  
G. ABBIATI ◽  
G. DELARIA ◽  
E. SAPORITI ◽  
M. PETROLATI ◽  
C. TREMOLADA
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Extension Deficit ◽  
Flexion Contractures ◽  
Complete Extension ◽  
Pip Joint ◽  
Surgical Release

A method of treatment of chronic flexion contractures of the PIP joint is presented, with the results obtained in 19 patients treated between 1989 and 1992 after a follow-up of from 6 to 53 months. The flexion contractures, with an extension deficit which ranged between 70 and 90°, had been present for a period of between 2 months and 24 years. Our treatment program involves the surgical release of the unreducible PIP joint followed by the use of static and/or dynamic splints. Surgery is performed using a midlateral approach; the accessory collateral ligament and the flexor sheath are incised and, after the volar plate and check-rein ligaments have been excised, forced hyperextension is applied. The main collateral ligaments are carefully spared and freed from the condyle if there are any remaining adhesions. In our 19 patients, complete extension of the finger was achieved in 11 cases (57.9%); in the remaining 8 cases (42.1%) the residual extension deficit ranges from 10 to 15°. In our experience this combined surgical and rehabilitative approach had led to consistently good results with minimal complications.

Alternative Method of Repairing Collateral Ligament Injuries at the Metacarpophalangeal Joints of the Thumb and Fingers

1997 ◽  
Vol 22 (6) ◽  
pp. 736-738 ◽  
Author(s):  
G. D. BEAUPERTHUY ◽  
E. F. BURKE
Keyword(s):  
Suture Anchor ◽  
Collateral Ligaments ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Metacarpophalangeal Joints ◽  
Uninjured Side ◽  
Alternative Method ◽  
Partial Tears

Injuries to the joints of the thumb and fingers frequently cause complete or partial tears of the collateral ligaments, resulting in marked instability of the involved joint. Twelve patients with 12 unstable metacarpophalangeal joints were treated surgically with a Mitek® metal suture anchor. At the last postoperative follow-up (range 6 weeks-6 months) 11 of 12 patients had good to excellent results subjectively and had regained 75% of the strength of the uninjured side.

scholarly journals Open reduction, triceps lengthening, and collateral ligaments reconstruction in neglected elbow dislocation: a case report

2020 ◽  
Vol 8 (12) ◽  
pp. 4488
Author(s):  
Henry Tirtosuharto ◽  
Made Bramantya Karna ◽  
Anak Agung Gde Yuda Asmara ◽  
Putu Feryawan Meregawa
Keyword(s):  
Open Reduction ◽  
Articular Surface ◽  
Elbow Dislocation ◽  
Tendon Graft ◽  
Fascia Lata ◽  
Collateral Ligaments ◽  
Range Of Movement ◽  
Left Elbow ◽  
Satisfactory Outcome ◽  
Elbow Contracture

Neglected elbow dislocations are common in developing countries. Neglected elbow dislocation leads to retraction of triceps muscles and collateral ligaments. This cause limitation of range of movement that is inadequate for the activities of daily living. A 48 years old man presented with stiffness on the left elbow. He fell down with arm in extension position 8 months prior to admission and was treated by a traditional bonesetter before seeking medical treatment. Active ROM of the left elbow was limited to 15ᵒ during flexion. The patient diagnosed as left elbow contracture due to neglected left elbow dislocation. Open reduction, MCL-LCL reconstruction and triceps lengthening was performed. Left elbow ROM was improved and MEPI score was good on 5 months evaluation. Open reduction surgery was done to avoid the risk of fracture or articular surface damage. The posterior approach provides good exposure to the retracted posterior structures and give easier access to perform V-Y plasty used for triceps lengthening. Collateral ligaments repair provides immediate stability and give better functional results. Docking technique was used for collateral ligaments repair using fascia lata tendon graft. Immobilization and physical rehabilitation are done to improve elbow joints range of movement. Open reduction surgery, triceps lengthening and collateral ligaments reconstruction using tendon graft from tensor fascia lata give satisfactory outcome for elbow contracture due to neglected left elbow dislocation.

scholarly journals Irreducible Elbow Dislocation Associated with Hill?Sachs-like Lesion over the Capitellum

2019 ◽  
Vol 22 (1) ◽  
pp. 37-39
Author(s):  
Hung-Kai Weng ◽  
Wei-Lun Chang ◽  
Ming-Long Yeh ◽  
Wei-Ren Su ◽  
Kai-Lan Hsu
Keyword(s):  
Computed Tomography ◽  
Range Of Motion ◽  
Elbow Dislocation ◽  
Coronoid Process ◽  
Computed Tomography Images ◽  
Acceptable Range ◽  
Digital Pressure ◽  
Patient Reported ◽  
The Hill

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill?Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill?Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

Anatomical collateral ligament reconstruction in the hand using intraosseous suture anchors and a free tendon graft

2012 ◽  
Vol 37 (9) ◽  
pp. 832-838 ◽  
Author(s):  
J. I. Lee ◽  
W. J. Jeon ◽  
D. H. Suh ◽  
J. H. Park ◽  
J. M. Lee ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Skin Irritation ◽  
Clinical Results ◽  
Tendon Graft ◽  
Bone Tunnel ◽  
Anatomical Reconstruction ◽  
Suture Anchors ◽  
Collateral Ligaments ◽  
Collateral Ligament

We describe anatomical collateral ligament reconstruction using a free tendon graft and intraosseous suture anchors in the digits. Eleven patients who underwent collateral ligament reconstruction at the proximal interphalangeal or metacarpophalangeal joints were enrolled in this study. Proper and accessory collateral ligaments were reconstructed using a free tendon graft in an anatomical configuration and the grafted tendons were fixed with suture anchors. The mean time from surgery to last follow-up was 9.2 months. All anchors used for fixation of grafted tendons remained securely at their original positions at the last follow-up visits. No significant complications were associated with the use of anchors. Clinical results were excellent in 10 patients and good in one. Anatomical reconstruction of collateral ligaments using suture anchors is simpler, faster, and safer than the conventional bone tunnel technique and it does not have the risks of breakage of bone bridges, skin irritation, or graft loosening.

Total Extrusion of the Talus in an Adolescent

2009 ◽  
Vol 99 (5) ◽  
pp. 431-434 ◽  
Author(s):  
Kaya Memisoglu ◽  
Ali Hürmeydan
Keyword(s):  
Range Of Motion ◽  
Avascular Necrosis ◽  
Open Reduction ◽  
Full Range ◽  
Cast Immobilization

Talar extrusion in a 13-year-old child was treated by means of open reduction and 10 weeks of cast immobilization. At 1.5 years of follow-up, the patient had full range of motion in the ankle and no signs of avascular necrosis or arthritis. (J Am Podiatr Med Assoc 99(5): 431–434, 2009)

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