Case 1: 23 year old female patient had a neglected poste-rior dislocation of left elbow with ipsilateral humeral shaft fracture caused by car accident. The mean followup was 48.3 months (range, 12–132 months). Conclusion: The goals of elbow rehabilitation following Neglected Monteggia cases include restoring function by restoring motion and muscle performance; influencing scar remodeling and preventing joint contracture; and restoring or maintaining joint stability. [email protected]. This may because of a better health education and healthcare system together with the decreasing of popularity to receive the treatment from traditional bonesetters. neglected elbow dislocations treated with open reduction and hinged external fixators. This is the reason that in more than ½ of the patients in our series, the duration of untreated elbow dislocation usually was between 1 and 3 months. An email with instructions to reset your password will be sent to that address. There were 18 men and six women whose ages ranged from 7 to 60 years (average, 24.6 years). ©1987 British Editorial Society ofBone and Joint Surgery 0301-620X/87/2038 $2.00 Fig. Elbow dislocations are common and account for 10-25% of all elbow injuries in the adult population 1. Elbow dislocations are the second most common joint dislocation, following shoulder dislocations. Descriptive statistics were computed for age at presentation, the duration of the dislocation, and preoperative and postoperative arcs of motion. endstream endobj 48 0 obj <> endobj 49 0 obj <> endobj 50 0 obj <>stream Only three patients in this study were older than 40 years and the oldest patient was 60 years. Introduction ‘Unreduced elbow’ is defined as a posterior elbow dislocation not treated within 3 weeks of injury.9, 13, 16, 18 Such an elbow is fixed in either extension or flexion, with only a few degrees of flexion, supination or pronation, and has a range of movement that is inadequate for the activities of daily living. Try again. You can login with your username or your email address along with your chosen password. The patients were operated on in two hospitals for late open reduction from 1980 to 1999. Only the elbow motions in flexion and extension were recorded. However, from our experience, the neglected elbow dislocation usually occurs in patients in low socioeconomic communities where there is poor patient compliance even if braces were available. The splint usually is discarded after 3–4 weeks after injury at the time that pain and swelling usually subside. To achieve stable and concentric reduction, the complete clearance of fibro-osseous tissue from the trochlear notch, the olecranon fossa, and the coronoid fossa and complete reduction of the radiohumeral joint are important. To investigate the effect of open reduction operative treatment in neglected elbow dislocation. The average preoperative arc of elbow flexion was from 17° with an average maximum flexion of 27° (range, 5–60°) and an average flexion contracture of 10° (range, 0–30°). Average elbow flexion was 46.0° ± 25.9° (10° to 90°) and the extension deficit was 19.5° ± 18.4° (0° to 60°) before the surgery. The study included two adults and four children who underwent open reduction for subacute, untreated posterior dislocation of the elbow. This figure shows the result of elbow motion in flexion and extension 3 years after open reduction of 7-week neglected elbow dislocation in a patient who was 10 years old at the time of surgery. 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