Open Reduction on very late-presenting unreduced posterior elbow dislocation: Still promising treatment option.

BACKGROUND: Neglected dislocation of the elbow is associated with instability, pain, and limitation of elbow function. In developing countries, neglected dislocations of the elbow are quite common, and most patients initially go to local bonesetters, which only aggravates the problem.

PRESENTATION OF CASE: Two patients with a history of unreduced posterior elbow dislocation for more than 1 year and were treated by a traditional bonesetter were included in this case study. The first case was a 65-year-old female with a history of injury around her right elbow around 12 months before admission. The patient underwent open reduction with triceps lengthening and immobilization with plaster of paris for 3 weeks. The second case was a 53-year-old male with a history of injury caused by a fall on an outstretched hand around 18 months before admission. The patient underwent arthrolysis followed by triceps lengthening, internal fixation with transarticular k-wire, and immobilization with elbow slab for 3 weeks.

DISCUSSION: To optimize treatment goals and patient function, various surgical approaches have been described for treating chronic elbow dislocations. The benefit of the VY triceps lengthening is to simplify the reduction procedure, especially in the elbow dislocations with greater chronicity. The downside of the VY lengthening is possible triceps weakness, delayed physiotherapy, and increased postsurgical pain. On the basis of this study, open reduction should remain a treatment option for patients regardless of age and chronicity of injury.

CONCLUSION: Operative treatment of late-presenting, unreduced elbow dislocation is effective in restoring the joint to a painless, stable, and functional limb.