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Dislocations of the elbow in children
1Department of Orthopaedic Surgery, Nelson R. Mandela School of Medicine, Private Bag 7, Congella 4013, Republic of South Africa.
Insights
Acute traumatic elbow dislocations in children often involve fractures and nerve injuries, requiring careful assessment. Surgical intervention is frequently needed, with most patients achieving good to excellent outcomes despite potential complications.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
Background:
- Elbow dislocations are uncommon in children but can lead to significant morbidity.
- Associated injuries, including fractures and neurovascular compromise, are frequent.
- Optimal management strategies require thorough evaluation.
Purpose of the Study:
- To review the management and outcomes of acute traumatic elbow dislocations in a pediatric population.
- To highlight the importance of comprehensive assessment for associated injuries.
Main Methods:
- Retrospective review of 33 pediatric patients treated for acute traumatic elbow dislocation between 1994 and 2002.
- Analysis of injury patterns, treatment methods, and complications.
Main Results:
- 30 posterior and 3 anterior dislocations were recorded.
- 25 patients had associated elbow fractures; 8 had pure dislocations.
- Neurovascular injuries occurred in 3 patients; 20 required open reduction.
- Complications included pseudarthrosis and loss of range of motion.
- Outcomes were excellent/good in 22, fair in 10, and poor in 1 patient.
Conclusions:
- Meticulous clinical and radiological assessment is crucial for identifying associated injuries in pediatric elbow dislocations.
- Prompt and appropriate management can lead to favorable outcomes, though complications may occur.
Abstract:
A total of 33 children were treated for acute traumatic dislocation of the elbow between 1994 and 2002; 30 dislocations were posterior and three anterior. Eight children had a pure dislocation and 25 had an associated fracture of the elbow. Two had compound injuries. Two children had injury to the ulnar nerve, one to the radial nerve and one to the median nerve together with injury to the brachial artery. Twenty required open reduction. Complications included pseudarthrosis of the medial epicondyle in one child and loss of flexion and rotation of between 10 degrees and 30 degrees in ten others. Meticulous clinical and radiological assessment is mandatory in children with dislocation of the elbow to exclude associated injuries. The results were excellent to good in 22 patients, fair in ten and poor in one.
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