title: Chronically unreduced posterior dislocation of the elbow.
abstract: BACKGROUND
  Chronically unreduced posterior dislocation of the elbow is a complex and difficult problem for the surgeon and its treatment significantly influences future functional performance of the patient. There are few reports in the literature regarding chronically unreduced dislocations, and most of them are based on observations of individual patients.
  
  
  METHODS
  A total of 9 patients with chronically unreduced posterior dislocations of the elbow were treated in the Department of Orthopaedics and Traumatology between 2004 and 2012. The mean time between injury and reduction was 5.6 weeks. Eight of the patients had a concomitant fracture of the radial head, 5 had a fracture of the coronoid process, and 8 demonstrated significant damage to the lateral collateral ligament complex. All patients were qualified for surgical reduction of the dislocation, and then, after a maximum of 2 weeks of immobilization in a plaster cast, the patients were referred for intensive physiotherapy. Stability, range of motion and elbow function according to the MEPI score were evaluated during follow-up visits.
  
  
  RESULTS
  Elbow instability did not occur in any of the patients during the follow-up. Complications in our patients included a posttraumatic contracture of the elbow, periarticular ossifications and loosening of the radial head endoprosthesis.
  
  
  CONCLUSIONS
  Recommendations for the management of these difficult cases are formulated.
authors.affiliation: Department of Traumatology and Orthopaedics The Medical Centre of Postgraduate Education, Prof. Adam Gruca Clinical Hospital, Otwock, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Pieniężna-Ćwirko
authors.affiliation: Department of Traumatology and Orthopaedics The Medical Centre of Postgraduate Education, Prof. Adam Gruca Clinical Hospital, Otwock, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Urban
authors.affiliation: Department of Traumatology and Orthopaedics The Medical Centre of Postgraduate Education, Prof. Adam Gruca Clinical Hospital, Otwock, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Zakrzewski
authors.affiliation: Department of Traumatology and Orthopaedics The Medical Centre of Postgraduate Education, Prof. Adam Gruca Clinical Hospital, Otwock, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Pomianowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011044:Poland; D017410:Practice Guidelines as Topic; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries