Results of open reduction for neglected elbow dislocations in adult patients

Abstract

Objective: To present the results of open reduction of neglected elbow dislocations using a consistent surgical protocol.
Patients and methods: Between 2000 and 2005 eight patients with neglected elbow dislocations were operated on using the Speed\'s posterior approach with lengthening of the triceps by V-Y musculoplasty. The average age of patients was 32.2 years.
The average delay from injury to the initial examination was 6.2 months. At the time of the initial presentation to hospital, all patients experienced elbow stiffness with non functional range of motion. Main outcome measure: Functional results were assessed
by measuring the active range of flexion-extension.
Results: All elbows had improved flexion at follow-up which ranged from three to eighteen months (average 10.7 months). The average arc of flexion improved from 21° (range 0° to 45°) to 82° (range 40° to 140°). The average maximum flexion at the elbow
improved from 60° (range 30° to 85°) to 99° (range 70° to 140°). The mean flexion contracture at the elbow decreased from 39° to 18°. No patient had recurrence of dislocation.
Conclusion: The Speed technique is a viable option in treating non functional neglected elbow dislocations. The midterm results are encouraging although they are mainly hampered by inadequate follow-up and difficulties in performing the rehabilitation program in low-income countries.

Keywords: Elbow, Neglected dislocation, Speed procedure

Nigerian Journal of Orthopaedics and Trauma Vol. 7 (1) 2008 pp. 13-16