Abstract
Introduction and Aims: To review paediatric elbow dislocations treated in our institution over a ten year period and assess outcome
Method: Prospective data collected on elbow injuries in our unit was used to identify elbow injuries and elbow dislocations over a ten-year period. Thereafter, a comprehensive case note and radiological review was performed
Results: 1761 elbow injuries exclusively treated in our unit in a ten-year period. Sixty-three elbow dislocations were identified. Male to female preponderance of around 2:1 (44:19), left more common than right (37:26). There was a seasonal variation. Eighty percent of all dislocations occurred as a result of a low fall or simple sporting injury. Sixty of the 63 dislocations were posterior with two anterior and one divergent dislocation. Associated fractures were common (46%), with 33% of patients having a medial epicondylar fracture in association with their dislocation, other fractures were rare. Two dislocations were open; there were two neuropraxias and no vascular complications. Twelve cases were reduced with sedation and analgesia with the remainder undergoing general anaesthetic. Closed reduction was possible in all cases. Reduction of fracture dislocations under sedation was associated with a higher incidence of medial epicondyle entrapment in the joint compared with general anaesthetic reduction. Post-operative management consisted on average of three weeks in plaster. No significant long-term loss of movement occurred in any patient. In the timeframe used there was one re-dislocation and no re-referrals for ongoing instability.
Conclusions: Paediatric elbow dislocations represent around 3.5% of all paediatric elbow injuries. Although closed reduction is almost always possible, fracture dislocations should be reduced under general anaesthesia. Unlike in adults there appears to be problem with immobilisation for up to five weeks and the results of conservative treatment are excellent.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
