RM Vignesh Karthik*

Department of Orthopaedics, SPMM Hospital, Salem, India

*Corresponding Author: RM Vignesh Karthik, Department of Orthopaedics, SPMM Hospital, Salem, India.

Received: September 29, 2022; Published: November 21, 2022

Abstract

Background: This case report is to highlight the red flag for ligamentous injury in elbow dislocation cases which reduce into position without much effort. All cases of easily reducible elbow dislocations warrant a CT scan and dynamic examination using an image intensifier to identify the torn ligaments. This aids in early reconstruction of the torn ligaments and better rehabilitation.

Patient and Method: An office going young lady sustained injury to her right elbow. She was diagnosed with posterior elbow dislocation which reduced into position with just a gentle push on the olecranon. She underwent dynamic radiological examination which revealed an unstable medial support with coronoid fracture. She was assessed for surgery and underwent open reduction and fixation of the coronoid fragment, followed by medial collateral ligament repair.

Result: At 6 months follow up she has regained full range of movements with no instability.

Conclusion: Easy reduction of dislocated elbow is a red flag for bony avulsion/ligamentous injury and warrants complete radiological workup including dynamic x rays. Prompt and early ligament reconstruction re-establishes the stability of the joint.

Keywords: Elbow Instability; Elbow Dislocation; Elbow Ligament Reconstruction; Coronoid Fracture

References

1. Christopher Forthman., et al. “Ring Elbow dislocation with intra-articular fracture: the results of operative treatment without repair of the medial collateral ligament”. Journal of Hand Surgery (American Volume) 8 (2007): 1200-1209.
2. Forthman C., et al. “Elbow dislocation with intra- articular fracture: the results of operative treatment without repair of the medial collateral ligament”. Journal of Hand Surgery (American Volume) 8 (2007): 1200e1209.
3. Chen NC and Ring D. “Terrible triad injuries of the elbow”. Journal of Hand Surgery (American Volume) 11 (2015): 2297e2303.
4. Giannicola G., et al. “Terrible triad of the elbow: is it still a troublesome injury?” Injury 8 (2015): S68eS76.
5. Pierrart J., et al. “Terrible triad of the elbow: treatment protocol and outcome in a series of eighteen cases”. Injury1 (2015): S8eS12.
6. Tarassoli P., et al. “Complex instability of the elbow”. Injury3 (2017): 568e577.
7. Rhyou IH and Kim YS. “New mechanism of the posterior elbow dislocation”. Knee Surgery, Sports Traumatology, Arthroscopy12 (2012): 2535e2541.
8. Mellema JJ., et al. “Quantitative 3- dimensional computed tomography measurements of coronoid fractures”. Journal of Hand Surgery (American Volume) 3 (2017): 526e533.
9. Shuo Chen., et al. “Biomechanical study on posterolateral rotatory instability of elbow in coronoid process fracture with anterior bundle injury of medial collateral ligament”. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi2 (2010): 215-218.
10. Ring D., et al. “Posterior dislocation of the elbow with fractures of the radial head and coronoid”. Journal of Bone and Joint Surgery. America4 (2002): 547e551.
11. Pugh DM., et al. “Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures”. Journal of Bone and Joint Surgery. America6 (2004): 1122e1130.
12. Jeong WK., et al. “Results of terrible triads in the elbow: the advantage of primary restoration of medial structure”. Journal of Orthopaedic Science5 (2010): 612e619.
13. Giannicola G., et al. “Management of complex elbow instability”. Musculoskeletal Surgery1 (2010): S25eS36.
14. Rodriguez-Martin J., et al. “Outcomes after terrible triads of the elbow treated with the current surgical protocols: a review”. International Orthopaedic6 (2011): 851e860.
15. Morrey BF and An KN. “Stability of the elbow: osseous constraints”. Journal of Shoulder and Elbow Surgery 14 (2005): 174se178s.
16. Morrey BF., et al. “Valgus stability of the elbow: a definition of primary and secondary constraints”. Clinical Orthopaedics and Related Research 265 (1991): 187e195.
17. Cho CH., et al. “Acute severe valgus instability without elbow dislocation”. Journal of Shoulder and Elbow Surgery8 (2015): e212ee217.
18. Doornberg JN., et al. “Coronoid fracture height in terrible-triad injuries”. Journal of Hand Surgery (American Volume) 5 (2006): 794e797.
19. Jae Sung Lee., et al. “Analysis of Fracture Characteristic and Medial Collateral Ligament Injury Relationships in Terrible Triad Elbow Injuries”. Journal of Hand Surgery (American Volume) 46 (2021).

Citation

Citation: RM Vignesh Karthik. “Silent Elbow Joint Relocation - A Red Flag for Medial Collateral Ligament Instability Needing Repair”.Acta Scientific Orthopaedics 5.12 (2022): 169-176.

Copyright

Copyright: © 2022 RM Vignesh Karthik. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.