Abstract
Background: Posterior dislocation of the elbow with fractures of the radial head and coronoid process is a rare injury which, when treated conservatively, has a high redislocation rate and poor results (7/11 in the largest published series). Methods: Six patients with this injury were treated with triple reconstruction, involving exploration of the joint via a lateral approach with insertion of a radial head prosthesis. The coronoid fracture and anterior capsule was repaired (using an in-to-out technique) and the lateral collateral ligament was reat-tached, using Mitek Super Anchors. All patients were evaluated prospectively. Results: The average age was 52 years (37–75y). At one year follow up all elbows remained in joint and all were pain free or causing slight pain only. The average range of ulno-humeral movement was 55 degrees (range 38–68) and the average forearm rotation was 67 degrees (range 18–104). Functional assessment showed an average Liverpool score of 23/36 (range 17–29) and average Broberg and Morrey score of 74/100 (range 68–84). Conclusions: Triple reconstruction recognises and remedies the three elements of this devastating injury. All of these must be addressed in order to fulþll the short-term goal of restoring and maintaining stability. Our patients have a stable, pain free, though stiff, elbow in contrast to the poor results reported from previous conservative and operative treatments.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
