Guzmán R, Rincón D, Camacho J

Language: Spanish
References: 14
Page: 118-122
PDF size: 509.04 Kb.

ABSTRACT

Elbow dislocation in children is a very infrequent traumatic event which was first described by Stimson in 1900 and then by Tachdjian in 1990. Its estimated incidence ranges from 3% to 6% of all elbow injuries, peaking at 13-14 years. Elbow trauma is classified considering the direction in which the proximal radioulnar joint shifts with respect to the humerus, into posterior and anterior dislocation. The former is the most frequent and accounts for 95% of cases. Elbow fracture dislocation is an even rarer event. The incidence rate of avulsion fracture of the medial epicondyle is 25-36%, of the lateral condyle 4%, of the olecranon 1.7%, of the radial head 8%, of the coronoid process 3.5%, and others, 3.5%. At present there is no consensus in the literature on how to treat this type of lesions, particularly because some authors advocate nonsurgical management, while others propose surgical management as the definitive treatment. What is clear, however, is that a late diagnosis or untimely treatment may affect the child’s growth and lead to serious complications. The purpose of this study is to share our experience and good results with the surgical management of these infrequent cases.

REFERENCES

1. Lieber J, Zundel SM, Luithle T, Fuchs J, Kirschner HJ: Acute traumatic posterior elbow dislocation in children. J Pediatr Orthop B. 2012; 21(5): 474-81.

2. Sharma H, Ayer R, Taylor GR: Complex pediatric elbow injury: an uncommon case. BMC Musculoskelet Disord. 2005; 6: 13.

3. Stavros R, Haris SV, Stamatis M: Conservative treatment of posterolateral dislocation of the elbow with medial epicondyle fracture in children between 6 and 8 years old. A report of three cases, literature review. Injury Extra. 2007; 38(11): 417-21.

4. Rasool MN: Dislocations of the elbow in children. J Bone Joint Surg Br. 2004; 86(7): 1050-8.

5. Martín JR, Mazzini JP: Posterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report. Cases J. 2009; 2: 6603. doi: 10.4076/1757-1626-2-6603.

6. Saraf SK, Tuli SM: Concomitant medial condyle fracture of the humerus in a childhood posterolateral dislocation of the elbow. J Orthop Trauma. 1989; 3(4): 352-4.

7. Haflah NH, Ibrahim S, Sapuan J, Abdullah S: An elbow dislocation in child with missed medial epicondyle fracture and late ulnar nerve palsy. J Pediatr Orthop B. 2010; 19(5): 459-61. doi: 10.1097/BPB.0b013e32833b6032.

8. Saied A, Moussavi AA: Elbow dislocation translocation in a child: a case report. J Shoulder Elbow Surg. 2007; 16(6): e17-9. Epub 2007 Apr 19.

9. Cheng PG, Chang WN, Wang MN: Posteromedial dislocation of the elbow with lateral condyle fracture in children. J Chin Med Assoc. 2009; 72(2): 103-7. doi: 10.1016/S1726-4901(09)70033-4.

10. Subramaniam, Mahendran, Hussin, Paisal. Medial epicondyle fracture with associated elbow dislocation in an adolescent. Internet Journal of Orthopedic Surgery. 2007: 9(2): 15312968.

11. Bulut G, Erken HY, Tan E, Ofluoglu O, Yildiz M: Treatment of medial epicondyle fractures accompanying elbow dislocations in children. [Article in Turkish]. Acta Orthop Traumatol Turc. 2005; 39(4): 334-40.

12. Fowles JV, Slimane N, Kassab MT: Elbow dislocation with avulsion of the medial humeral epicondyle. J Bone Joint Surg Br. 1990; 72(1): 102-4.

13. Gottschalk HP, Eisner E, Hosalkar HS: Medial epicondyle fractures in the pediatric population. J Am Acad Orthop Surg. 2012; 20(4): 223-32. doi: 10.5435/JAAOS-20-04-223.

14. Cheng JC, Wing-Man K, Shen WY, Yurianto H, Xia G, Lau JT, et al: A new look at the sequential development of elbow-ossification centers in children. J Pediatr Orthop. 1998; 18(2): 161-7.