Open reduction and Kirschner wire fixation with triceps lengthening for neglected elbow dislocations

Area of Science:

• Orthopedic Surgery
• Traumatology
• Reconstructive Surgery

Background:

• Neglected elbow dislocations can lead to significant functional impairment and stiffness.
• Surgical intervention is often required to restore elbow function in chronic cases.

Purpose of the Study:

• To evaluate the outcomes of open reduction and Kirschner wire fixation with triceps lengthening for neglected elbow dislocations.
• To assess the impact of dislocation duration and patient age on surgical results.

Main Methods:

• A retrospective review of 20 patients (6 women, 14 men) aged 7-60 years with neglected elbow dislocations.
• Surgical technique involved open reduction, Kirschner wire fixation, and triceps lengthening.
• Outcomes were assessed using the Mayo Elbow Performance Index (MEPI) and range of motion.

Main Results:

• The mean follow-up was 39.1 months, with a mean MEPI score of 79.3.
• Patients treated within 45 days of dislocation had significantly better MEPI scores (86.4) and range of motion compared to those treated later (70.6).
• A negative correlation was found between MEPI and dislocation duration (r=-0.562, p=0.01), and between range of motion and patient age (r=-0.649, p=0.002).

Conclusions:

• Open reduction and Kirschner wire fixation with triceps lengthening provide favorable results for neglected elbow dislocations.
• Shorter duration of dislocation (less than 45 days) and younger patient age are associated with improved outcomes.
• Active postoperative elbow mobilization is crucial for achieving optimal functional recovery.