Morphology and treatment of elbow dislocation associated with elbow fracture in children / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the morphological characteristics of elbow dislocation associated with elbow fracture in children,to propose its injury mechanism,and to present its treatment and outcomes.Methods From January 2010 to September 2016 in Department of Pediatric Orthopedics,the Affiliated Hospital of Zunyi Medical College,the clinical data of elbow dislocation associated with elbow fracture were retrospectively analyzed in 12 children,in which there were 9 boys and 3 girls with a mean age of 7.6 (3.6-12.O) years,and the injury time was 6 h-32 days,with an average of 3.5 days.According to the direction of dislocation,posterior dislocation in 6 cases,posterolateral dislocation in 4 cases,and anterior dislocation in 2 cases.Twelve cases were caused by high energy injury,accompanied with violent rotary injury of forearm,including traffic accident injury in 5 cases,high fall injury in 4 cases,motor belt injury in 2 cases,and washing machine injury in 1 case.All these cases were treated with surgery,the dislocated elbow joint were reset,the fracture fragments were fixed with Kirschner wire or wire tension band,and the lateral collateral ligament were repaired.Results All cases were followed up for 6-23 months,with an average 13.5 months.The stability of elbow joint and the fracture healing were very good,and no elbow redislocation at the last follow-up.The function of elbow joint recovered satisfactorily,the extension-flexion motion ranged from 90°-145°,with an average of 125°,and the pronation-supination motion ranged from 85°-155°,with an average of 130°.According to the Mayo functional index,the results were excellent in 7 cases and good in 4 cases,and the excellent and good ratio was 91.7％ (11/12 cases).Conclusions The elbow dislocation of children is caused by high energy injuries and the violent rotational injury of the forearm,easily combined with different types of elbow fractures and severe injury of collateral ligament.Surgical treatment should be actively performed to restore the normal anatomy,reconstruct the stability and restore the function of the elbow joint.