Abordaje medial modificado para dislocación codo crónico: un abordaje quirúrgico novedoso con buen resultado funcional / Modified medial approach for chronic elbow dislocation: a novel surgical approach with good functional outcome

ABSTRACT

Background : Chronic elbow dislocation is defined as untreated elbow dislocation for longer than 2 weeks. Goal of treatment is stable reduction of elbow joint and facilitation of early elbow motion for optimal end result. Known operative methods is the Kocher posterolateral approach.which can accumulate hematome, and longer time needed to identify Ulnar nerve. Therefore, we would like to introduce the new modified medial elbow joint incision approach. Methodology: This study utilized a cross-sectional review of patients with surgical treatment of simple chronic elbow dislocation. Questionnaires were taken using Oxford Elbow Score, Mayo Elbow Performance Index, and Disability of Arm, Shoulder, and Hand Questionnaire to assess current elbow status Result : Utilizing Oxford elbow score, the analytic group score value ranged from 21-46, while control group's score value were 37-42 (P-value <0.0001). Mayo Elbow Performance Index score, from the analytic group, scored ranges from 45 - 82. the control group, a mean value of 85 were scored (P-value <0.0001), the DASH score revealed total mean value of 8.3 in the analytic group, compared to score 6 in the control group (P-value = 0.0468 ). The range of motion is increased in total flexion and extension from both groups(P-value <0.0001) Conclusion: Modified medial elbow approach provides faster method of identifying ulnar nerve, requires less skin flap for closure and less space for blood accumulation. Modified medial elbow approach provides good functional outcome with no complications related to ulnar nerve reported in this study.