Open reduction in neglected elbow dislocation in children: a case series

BACKGROUND Elbow deformity in children due to neglected proper fracture management is a devastating condition. The stiffness and pain complicated the function in daily activity. Successful management of neglected elbow dislocation is a challenging problem for orthopedic surgeons. In this study, we aimed to evaluate results of open reduction for neglected elbow dislocation in children. CASE DESCRIPTION This is a case series of 13-14 years old neglected elbow dislocations, for up to 15 months. Open reduction after external distractor and followed by intensive rehabilitation was implemented. Clinical and functional outcome were evaluated within 4-7 years. Initial average elbow flexion was 53,3 degrees, extension was 0 degrees, arc of flexion was 53,3 degrees, arc of pronation-supination was 150 degrees and Mayo Elbow Performance Index (MEPI) was 80. Clinical and functional outcome were evaluated within 4-7 years. At follow-up after open reduction, the improvement in whole range of movement was significant. Average elbow flexion was 118,3 degrees, extension was 36,67 degrees, arc of flexion was 81,67 degrees, arc of pronation-supination was 133 degrees. The average improvement of flexion was 65 degrees, arc of flexion was 31,67 degrees, and arc of pronation-supination was 8,3 degrees. The average loss of flexion was 15,5%, arc of flexion was 44,2%, and arc of pronation-supination was 10,7% compared with uninjured side. The average Mayo Elbow Performance Index (MEPI) was 96,67; all with excellent results. CONCLUSION Planned and well execution open reduction in pediatric neglected elbow dislocation may bring back the painless movement within normal daily function.