Elbow Dislocations, Instability and Contracture-Surgical Treatment of Persistent Dislocation or Subluxation of the Ulnohumeral Joint After Fracture-Dislocation of the Elbow

Surgical Treatment of Persistent Dislocation or Subluxation of the Ulnohumeral Joint After Fracture-Dislocation of the Elbow

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This study reviewed the results of surgical reconstruction of posttraumatic elbow instability using a protocol that incorporated hinged elbow fixation. Thirteen patients with ulnohumeral instability after a fracture-dislocation of the elbow were included in the study. The patients underwent temporary hinged external fixation, preservation or reconstruction of the coronoid process and radiocapitellar contact, as well as repair or reconstruction of the lateral collateral ligament complex. At an average follow-up of 57 months, stability was restored in every patient. The average Disabilities of the Arm, Shoulder, and Hand questionnaire score was 15 and the average Mayo score was 84, with 6 excellent, 4 good, and 3 fair results. The average arc of ulnohumeral motion was 99°. Six patients had radiographic signs of arthrosis. The study concluded that a stable, functional elbow can be restored in most patients with persistent instability after a fracture-dislocation of the elbow using a treatment protocol incorporating hinged external fixation. However, it should be noted that this was a small study with a highly selected group of patients, and further research is needed to validate these findings.

Keywords

surgical reconstruction

posttraumatic elbow instability

hinged elbow fixation

ulnohumeral instability

fracture-dislocation

coronoid process

radiocapitellar contact

lateral collateral ligament complex

Disabilities of the Arm, Shoulder, and Hand questionnaire

Mayo score