Posterior elbow dislocation with associated vascular injury after blunt trauma.
BACKGROUND
Injury of the brachial artery is a rare (5-13%) but serious complication after closed elbow dislocation without associated fractures.


METHODS
Retrospective analysis of long-term results (mean, 4.1 years) in four patients.


RESULTS
All patients underwent emergency repair of the arterial injury within 2.5 hours. In three patients, a reversed saphenous vein graft was used; in one patient the artery was sutured. This latter patient needed another operation with interposition of a reversed saphenous graft, because the primary anastomosis occluded. The capsule and the collateral ligaments were immediately reconstructed in three patients because of instability. No patient showed claudication of the arm. In three patients, a sensory deficiency of median nerve persisted. Average range of motion was 128 degrees of flexion (120-135 degrees) and an extension deficit of 7.5 degrees (15-0 degrees).


CONCLUSIONS
Primary repair of vascular injury after closed elbow dislocation with vein graft and immediate reconstruction of ligamentous injuries results in good long-term functional outcome.
Platz
A
A
Department of Surgery, University Hospital Zurich, Switzerland. andreas.platz@chi.usz.ch
Heinzelmann
M
M
Ertel
W
W
Trentz
O
O
D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000293:injuries* / Q000601:surgery; D004551:Elbow Joint / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D000092464:Elbow Injuries