TOTBİD Dergisi

TOTBİD Dergisi

2014, Cilt 13, Sayı, 1     (Sayfalar: 043-050)

Simple elbow dislocations

Mehmet Oğuz Durakbaşa 1

1 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2014.06
Görüntüleme: 52
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İndirme : 42

Simple elbow dislocation consists of the elbow dislocations with soft-tissue injuries only or with extra-articular avulsion fractures; it is classified according to the direction or the timing of the dislocation. Fall on an outstretched hand is the most common etiologic mechanism. It is postulated that pathologic external forearm rotation results in an elbow dislocation. Axial loading transmitted through the body to the elbow joint as well as valgus or varus loading determines the grade and the sequence of the soft tissue injury. It is reported that the sequence of injury is from medial to lateral in posterolateral dislocation and from lateral to medial in posteromedial dislocation as a consequence of valgus and varus loading respectively. Coronoid process avulsion fracture is accepted as an instability criterion for this kind of dislocations. Simple elbow dislocation is diagnosed by clinical and radiographic examination. Radiographs of the opposite side are very useful in detecting the medial and lateral epicondyle fractures especially in adolescents. Computerized tomography and three dimensional computerized tomography have to be taken for every patient in order to detect the avulsion fractures or intraarticular osteochondral fracture fragments. Magnetic resonance (MR) imaging is the preferred examination tool in unstable elbow dislocation for the assessment of the soft tissue injury. Stable simple elbow dislocations are treated by closed reduction, splinting not more than 10 days, and applying immediate range of motion exercises; for unstable ones, turnbuckle orthosis in pronation with and without an extension block or surgery are indicated. Contracture, heterotopic ossification, neurovascular injury, Essex-Lopresti injury and residual instability are the complications encountered after simple elbow dislocations.

Anahtar Kelimeler : simple elbow dislocation; pathologic external forearm rotation; instability; complications