Elbow dislocation with irreparable fracture radial head.

Abstract

Treatment of elbow dislocation with irreparable radial head fracture needs replacement of radial head to achieve stability of elbow. An alternate method in cases of elbow dislocation with radial head fracture can be resection of radial head with repair of medial collateral ligament. We report a retrospective analysis of cases of elbow dislocation with irreparable radial head treated by excision head of radius and repair of MCL. Nine patients of elbow dislocation with associated irreparable fractures of the head of the radius were included in this analysis (6 F:3 M, Age: 35-47 years). Radial head excision was done through the lateral approach and MCL was sutured using no 3 Ethibond using medial approach. Above elbow plaster was given for 6 weeks and gradual mobilization was done thereafter. All patients were assessed at final followup using Mayo elbow performance score (MEPS). Mean followup was 19.55 ± 7.12 months (range 14-36 months). There was no extension deficit when compared to opposite side with mean range of flexion of 138.8° ± 6.97° (range 130 -145°). Mean pronation was 87.7° ± 4.4° (range 80-90°) and mean supination was 87.7 ± 4.62° (range 80-90°). The mean MEPS was 98.8 ± 3.33 (range 90-100). No patient had pain, sensory complaints, subluxation or redislocation. All were able to carry out their daily activities without disability. Radial head excision with MCL repair is an acceptable option for treatment of patients with elbow dislocation and irreparable radial head fracture.