[Neglected fracture-dislocation of the elbow: surgical reduction with enlarging osteoplasty of the trochlear notch. Case report].
Elbow dislocations in the infant are not very frequent and are associated to the fractures. Their management must be urgent and rigorous if complications are to be avoided. We report the case of a child aged 12 who presented with a fracture-dislocation of the right elbow, after falling from a tree. The patient was treated in a standard manner for one month. Four months later, the patient presented again, this time complaining of stiffness of the elbow. Physical examination confirmed the reduced range of movement of the elbow (flexion 80 degrees, extension -30 degrees) without associated neurovascular complication. Radiography of the elbow showed a posterior dislocation with remodelling of the humeral contours. Surgical exploration revealed normal articular cartilage, a pseudoarthrosis of the epitrochlea, a dislocation of the radial head and the sigmoid fossa of small size in relation to the trochlea. A reduction was only possible after an "enlargement plasty" of the trochlear notch. The patient was seen after an interval of six months. The elbow was stable with no vasculo-nervous complication.and had flexion of 110 degrees with extension of -30 degrees.
Ait Essi
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Service de traumato-orthopédie (Pavillon 32), CHU de Ibn-Rochd, BP 15199 Casa principal, Casablanca, Maroc. aefouad@yahoo.fr
Rafai
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M
Largab
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Trafeh
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D002648:Child; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011542:Pseudarthrosis / Q000175:diagnosis / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D000092464:Elbow Injuries