Journal of Orthopaedics and Allied Sciences

ORIGINAL ARTICLE
Year
: 2014  |  Volume : 2  |  Issue : 2  |  Page : 45--51

A new technique for surgical management of old unreduced elbow dislocations: Results and analysis


Parag Garg, Soumya Paik, Sisir Sahoo, Vimal Raj, Aniruddha Pispati, Subhashish Mitra 
 Department of Orthopedics, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India

Correspondence Address:
Parag Garg
Room No. 219, Doctors Quarters, Seth Sukhlal Karnani Memorial Hospital, AJC Bose Road, Kolkata - 700 020, West Bengal
India

Background: Open reduction of neglected dislocations of elbow often leads to less than optimal results. Extensive release during reduction and early mobilization may lead to instability. Post-surgical immobilization to recover the stability leads to loss of range of motion. Arafiles described a technique of creating a cruciate ligament like structure to provide stability while early mobilization is advocated. We have modified this technique in several aspects. We report a retrospective analysis of 26 such cases where we evaluated and compared the standard immobilization technique of K-wires with this new modified technique. Materials and Methods: Twenty-six consecutive cases of dislocated elbow with duration ranging from 4 to 56 months were included in this study. We performed standard open reduction and fixation with K-wire followed by immobilization for 3 weeks for the first 12 cases. In the next 14 cases after standard release and reduction we provided extra stability by adding a cruciate ligament like structure both on the medial and lateral side using autologous semitendinosus graft. Post-operative mobilization was advised the very next day. We evaluated the results of this technique and compared it with the previous one using MEPI scores, complication rate and radiological evaluation.Results: The average follow-up duration for the 26 patients is 4.5 years (2−7 years). All patients achieved full functional ROM in both planes. The mean increase in the MEPI score was significantly more for group II (53.5) than group I (36.6). Movement, activities and stability was better for this group II. Complication rates for both were similar.Conclusion: Providing stability at the time of operation with a mediolateral cruciate ligament provides the option of immediate mobilization post-operatively in open reduction of neglected dislocations of elbow. Thus, this technique provides excellent results disregarding the duration of dislocation with minimal morbidity for the patient.


How to cite this article:
Garg P, Paik S, Sahoo S, Raj V, Pispati A, Mitra S. A new technique for surgical management of old unreduced elbow dislocations: Results and analysis .J Orthop Allied Sci 2014;2:45-51


How to cite this URL:
Garg P, Paik S, Sahoo S, Raj V, Pispati A, Mitra S. A new technique for surgical management of old unreduced elbow dislocations: Results and analysis . J Orthop Allied Sci [serial online] 2014 [cited 2020 Aug 9 ];2:45-51
Available from: http://www.joas.in/article.asp?issn=2319-2585;year=2014;volume=2;issue=2;spage=45;epage=51;aulast=Garg;type=0