Primary total elbow replacement in a patient with old unreduced complex posterior elbow dislocation

Area of Science:

• Orthopedic Surgery
• Trauma Surgery

Background:

• Neglected elbow dislocations, especially with associated fractures, present complex challenges in orthopedic trauma.
• Delayed treatment can lead to chronic pain, stiffness, and functional deficits, significantly impacting patient quality of life.

Observation:

• A 65-year-old female presented with a 2-month history of a fall on an outstretched hand, resulting in a neglected posterior elbow dislocation with radial head and coronoid process fractures.
• Clinical examination revealed swelling, tenderness, altered three-point relation, and a fixed flexion deformity of 50°, with a limited range of motion (50°–60°).

Findings:

• Radiographic evaluation confirmed the neglected unreduced posterior elbow dislocation and associated fractures.
• The patient underwent total elbow replacement using a third-generation sloppy hinged elbow prosthesis.
• Post-operatively, significant improvement in range of motion was observed: 30°–120° at 3 weeks and 20°–140° at 6 weeks.

Implications:

• Total elbow replacement can be an effective treatment option for complex, neglected elbow dislocations with fractures.
• Early and appropriate surgical intervention is crucial for optimal functional recovery and pain reduction in such cases.
• This case demonstrates the potential for substantial functional restoration and improvement in daily living activities following total elbow arthroplasty.