A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management

Elbow dislocation usually presents with a deformity and swelling, yet it can also present with neurological complication. Nerve injury with dislocation is common in the pediatric age group and is reported infrequently among adults. The most common nerve involved with dislocation is the ulnar nerve followed by the median nerve. The median nerve usually slips medially during dislocation and gets entrapped posterior to the medial epicondyle or it can get entrapped between the fractured medial epicondyle. Here, we describe a unique case of posterolateral elbow dislocation in a 30-year-old female patient with having lateral displacement of the median nerve and the mechanism probably by which the nerve got displaced laterally.

A 30-years-old female patient of right hand dominant came to us with a left elbow injury after a road traffic accident. Clinical and Radiological examination revealed a posterior-lateral dislocated elbow with a fracture of the radial head and lateral condyle avulsion. Clinically, there was a weakness and sensory hypoesthesia along the median nerve distribution over the left hand and forearm. Initially, closed reduction and splinting done. Later, a planned surgery with a lateral approach avulsed lateral condyle and radial head fixation done with relocation of the median nerve, which was displaced laterally.

There are numerous cases of elbow dislocation with nerve involvement and their complications have been previously described throughout literature. Here, we present a rare case of lateral displacement of the median nerve in a dislocated elbow and the possible mechanism with its management.