Skip to main content
Top
Published in: MUSCULOSKELETAL SURGERY 1/2013

01-06-2013 | Original Article

Dislocations of the elbow in children: long-term follow-up

Authors: G. L. Di Gennaro, M. Spina, M. Fosco, D. Antonioli, O. Donzelli

Published in: MUSCULOSKELETAL SURGERY | Special Issue 1/2013

Login to get access

Abstract

Background

Dislocation of the elbow in children is considered to be a benign injury in most cases. The aim of this paper is to evaluate whether this condition has late sequelae in the adult age. The study consisted of a retrospective evaluation of patients under 15 years old at the time of injury.

Methods

40 patients were selected for the follow-up evaluation. The mean age of the children at the time of injury was 10.9 years old (range 5–14 years). Four patients were lost to follow-up, so they were not considered for final clinical evaluation. For the other 36 patients, the follow-up examination was undertaken after an average of 15 years (range 7–22 years). The average age of the patients at the follow-up was 26 (range 18–34 years).

Results

At the end of follow-up period, there were few subjective complications. No redislocations occurred. None of the patients had been influenced by their elbow injury in their choice of occupation. X-rays were available for 27 patients. These were graded using Linscheid and Wheeler criteria and were excellent in 14 patients, good in 10 and fair in 3.

Conclusions

Dislocation of the elbow in children is a benign injury in the majority of cases and has a good prognosis in the adult age too in spite of extensive damage to the periarticular structures. Ectopic ossifications are a common finding, but only large periarticular ectopic ossifications were associated with a decrease in range on motion. Extension loss is the most common sequelae.
Level of evidence IV.
Literature
1.
go back to reference Carlioz H, Abols Y (1984) Posterior dislocation of the elbow in children. J Pediatr Orthop 4(1):8–12PubMedCrossRef Carlioz H, Abols Y (1984) Posterior dislocation of the elbow in children. J Pediatr Orthop 4(1):8–12PubMedCrossRef
2.
go back to reference Fowles JV, Slimane N, Kassab MT (1990) Elbow dislocation with avulsion of the medial humeral epicondyle. J Bone Joint Surg [Br] 72-B:102–104 Fowles JV, Slimane N, Kassab MT (1990) Elbow dislocation with avulsion of the medial humeral epicondyle. J Bone Joint Surg [Br] 72-B:102–104
3.
go back to reference Grimer RJ, Brooks S (1985) Brachial artery damage accompanying closed posterior dislocation of the elbow. J Bone Joint Surg [Br] 67-B:378–381 Grimer RJ, Brooks S (1985) Brachial artery damage accompanying closed posterior dislocation of the elbow. J Bone Joint Surg [Br] 67-B:378–381
5.
go back to reference Hofammann KE 3rd, Moneim MS, Omer GE, Ball WS (1984) Brachial artery disruption following closed posterior elbow dislocation in a child: assessment with intravenous digital angiography: a case report with review of the literature. Clin Orthop 184:145–149PubMed Hofammann KE 3rd, Moneim MS, Omer GE, Ball WS (1984) Brachial artery disruption following closed posterior elbow dislocation in a child: assessment with intravenous digital angiography: a case report with review of the literature. Clin Orthop 184:145–149PubMed
6.
go back to reference Josefsson PO, Danielsson LG (1986) Epicondylar elbow fracture in children: 35-year follow-up of 56 unreduced cases. Acta Orthop Scand 57:313–315PubMedCrossRef Josefsson PO, Danielsson LG (1986) Epicondylar elbow fracture in children: 35-year follow-up of 56 unreduced cases. Acta Orthop Scand 57:313–315PubMedCrossRef
7.
go back to reference Josefsson PO, Johnell O, Gentz CF (1984) Long-term sequelae of simple dislocation of the elbow. J Bone Joint Surg [Am] 66-A:927–930 Josefsson PO, Johnell O, Gentz CF (1984) Long-term sequelae of simple dislocation of the elbow. J Bone Joint Surg [Am] 66-A:927–930
10.
go back to reference Protzman RR (1978) Dislocation of the elbow joint. J Bone Joint Surg [Am] 60-A:539–541 Protzman RR (1978) Dislocation of the elbow joint. J Bone Joint Surg [Am] 60-A:539–541
13.
go back to reference Schwab GH, Bennett JB, Woods GW, Tullos HS (1980) Biomechanics of elbow instability: the role of medial collateral ligament. Clin Orthop 146:42–52PubMed Schwab GH, Bennett JB, Woods GW, Tullos HS (1980) Biomechanics of elbow instability: the role of medial collateral ligament. Clin Orthop 146:42–52PubMed
14.
go back to reference Simon D, Masquijo JJ, Duncan MJ, Kontio K (2010) Intra-articular median nerve incarceration after spontaneous reduction of a pediatric elbow dislocation: case report and review of the literature. J Pediatr Orthop 30(2):125–129. doi:10.1097/BPO.0b013e3181cf3bfd PubMedCrossRef Simon D, Masquijo JJ, Duncan MJ, Kontio K (2010) Intra-articular median nerve incarceration after spontaneous reduction of a pediatric elbow dislocation: case report and review of the literature. J Pediatr Orthop 30(2):125–129. doi:10.​1097/​BPO.​0b013e3181cf3bfd​ PubMedCrossRef
15.
go back to reference Wilkins KE (1996) Fractures and dislocations of the elbow region. In: Rockwood CA, Wilkins KE, King RE (eds) Fractures in children, 4th edn, vol 3. Lippincott-Raven, Philadelphia, pp 653–887. ISBN 0792373294 Wilkins KE (1996) Fractures and dislocations of the elbow region. In: Rockwood CA, Wilkins KE, King RE (eds) Fractures in children, 4th edn, vol 3. Lippincott-Raven, Philadelphia, pp 653–887. ISBN 0792373294
16.
go back to reference Danielsson LG (1986) Median nerve entrapment in elbow dislocation: a case report. Acta Orthop Scand 57:450–452PubMedCrossRef Danielsson LG (1986) Median nerve entrapment in elbow dislocation: a case report. Acta Orthop Scand 57:450–452PubMedCrossRef
17.
go back to reference Borris LC, Lassen MR, Christensen CS (1987) Elbow dislocation in children and adults. A long-term follow-up of conservatively treated patients. Acta Orthop Scand 58:649–651PubMedCrossRef Borris LC, Lassen MR, Christensen CS (1987) Elbow dislocation in children and adults. A long-term follow-up of conservatively treated patients. Acta Orthop Scand 58:649–651PubMedCrossRef
18.
go back to reference Wilmshurst AD, Millner PA, Batchelor AG (1989) Brachial artery entrapment in closed elbow dislocation. Injury 20:240–241PubMedCrossRef Wilmshurst AD, Millner PA, Batchelor AG (1989) Brachial artery entrapment in closed elbow dislocation. Injury 20:240–241PubMedCrossRef
19.
go back to reference Bensahel H, Csukonyi Z, Badelon O, Badaoui S (1986) Fractures of the medial condyle of the humerus in children. J Pediatr Orthop 6:430–433PubMedCrossRef Bensahel H, Csukonyi Z, Badelon O, Badaoui S (1986) Fractures of the medial condyle of the humerus in children. J Pediatr Orthop 6:430–433PubMedCrossRef
Metadata
Title
Dislocations of the elbow in children: long-term follow-up
Authors
G. L. Di Gennaro
M. Spina
M. Fosco
D. Antonioli
O. Donzelli
Publication date
01-06-2013
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue Special Issue 1/2013
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-013-0256-1

Other articles of this Special Issue 1/2013

MUSCULOSKELETAL SURGERY 1/2013 Go to the issue