Surgical treatment for patients of simple elbow dislocations with posteromedial instability

FENG Ming-guang; WANG Hai-yang; JIANG Xu-wei; XU Wen-feng; MAI Jia-jia

doi:10.3969/j.issn.2095-252X.2016.04.004

Abstract：Objective To investigate the injury mechanism of simple elbow dislocations with posteromedial instability, and to report the clinical results of the first-stage repair with wired anchor screws in injured ligament / tendon-capsule and early protected rehabilitation.Methods Data of 15 patients of simple elbow dislocations with posteromedical instability were reviewed by a retrospective analysis in our trauma center between January 2012 and June 2014. There were 11 males and 4 females with the mean age of 34 years ( range: 18 - 72 years ). Causes: moped accident in 12 cases, falling injury in 2 cases, fall over in 1 case. Wired anchor screws were used intraoperatively in injured ligament / tendon-capsule anatomical repair at the ifrst stage. Injury categories of the ligament, joint capsule and tendon were recorded. Relations between injuries of soft tissues and the elbow and correspondent violence were defined. Postoperative progressive functional rehabilitation training with the brace was conducted under the protection of the elbow. Regular outpatient follow-up was conducted.Results Avulsion injury was 100% for the medial collateral ligament and anteromedial capsule, 60% for the lfexor tendon and 30% for the biceps tendon. The elbow injury occurred in supination, abduction and valgus position. In the latest follow-up, the overall mean Mayo Elbow Performance Score was 93.2, ulnar nerve injury occurred in 5 elbows, and heterotopic calciifcation was noted in 1 patient.Conclusions Elbow extension and supination under axial hyperextension and valgus stress is the injury mechanism of simple elbow dislocations with posteromedial instability. It mainly involves anteromedial stable structure. Early repair with wired screws can achieve satisfactory results.