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Chronic Elbow Dislocation: Evaluation and Management.

Kenneth W Donohue¹, Thomas L Mehlhoff

¹From the Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX (Dr. Donohue) and the Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX (Dr. Mehlhoff).

The Journal of the American Academy of Orthopaedic Surgeons

|May 27, 2016

Summary

This summary is machine-generated.

Chronic elbow dislocation, unreduced for over two weeks, presents treatment challenges due to tissue changes. Management typically involves open reduction, often with external fixators, but optimal strategies require further research.

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Area of Science:

Orthopedic Surgery
Traumatology
Elbow Joint Biomechanics

Background:

Chronic elbow dislocation is defined as a dislocation unreduced for >2 weeks.
Develops significant soft-tissue and skeletal changes, hindering closed reduction.
Includes fibrotic tissue, contractures of surrounding structures, and potential ulnar nerve involvement or fractures.

Purpose of the Study:

To outline a stepwise approach for evaluating and managing chronic elbow dislocations.
To address the challenges associated with treating these complex injuries.
To highlight the limited data guiding treatment and reliance on anecdotal experience.

Main Methods:

Review of existing literature and clinical experience.
Emphasis on a stepwise evaluation process.
Discussion of surgical management, primarily open reduction and hinged external fixators.

Main Results:

Chronic elbow dislocations are difficult to treat due to established soft-tissue and bony changes.
Open reduction, frequently utilizing hinged external fixators, is the common treatment.
The efficacy of triceps lengthening or primary collateral ligament reconstruction is debated.

Conclusions:

Chronic elbow dislocation management is complex and often relies on surgeon experience.
A structured approach is necessary for evaluation and treatment planning.
Further research is needed to establish evidence-based guidelines for optimal surgical interventions.