TREATMENT OF NEGLECTED COMPLEX DISLOCATIONS IN THE ELBOW JOINT (CLINICAL CASE)

Abstract

Neglected complex dislocations of the elbow joint are not often pathology, bat its treatment is serious problem and demand an individual tactic of treatment. Objective. To present a clinical case of consecutive treatment the neglected complex dislocations of the elbow. Methods. The clinical case of neglected complex dislocations to the back with coronoid process fracture II type (by Regan, Morrey) with displacement to a 60-year old man, who could not get medical care within 6 months. At the moment of examination patient had formed steadfast interrelations of displaced elbow joint structures with loosing of limb functionality. At the first stage, the forearm was distracted by using an external fixation device end redaction in the shoulder-elbow joint was achieved. At another stage arthrolysis, open redaction of the radial head, restoration of the lateral ligamentous apparatus was complected. In three weeks restoration of movements in the elbow joint has begun, ensuring movements close to the natural axis of the forearm rotation, which was provided by the external fixation device. Results. In 6 months the patient noted moderate pain only after intense physical load, hi doesn’t take painkillers, volume o f rotational m ovements: 2 0/0/25 (45°), e xtension-flexion movements: 0/15/118 (103°). The patient actively uses the limb for self-care and in work activities. According to the Mayo Elbow Performance Score the sum of points is 75, this means — the result is good. Conclusions. In cases of neglected complex dislocations for significant periods of existence (more than 3–4 months) staged treatment tactics is appropriate with using external fixation devices, by perforce perform open and closed manipulations, which depends on the specific clinical situation.