A rare case of neglected paediatric elbow dislocation treated with open reduction in tertiary care rural hospital of Nepal

Abstract

Old unreduced dislocation of elbow is rare1. However, they remain rather frequent in developing countries, because of the recourse of patients to the traditional medicine.2 Term ‘Unreduced’ is defined as those posterior elbow dislocations not treated within 3 weeks of injury.3These elbows are fixed in either extension or flexion with only a few degrees of flexion, supination, and pronation, and have a non-functional range of movement for activities of daily living.3,4The time since injury and patient age determine the mode of treatment.5 The likelihood of restoring useful function of the elbow by open reduction alone is inversely proportional to the time since injury.6There are many ways to treat chronic dislocation or fracture- dislocation of the elbow, including ORIF, excision arthroplasty, replacement arthroplasty, arthrodesis, and hinged external fixators.7 There has been considerable disagreement about the impact of such variables as the duration of the untreated dislocation, the age of the patient, the method of repair or reconstruction of the collateral ligaments, the performance of triceps or biceps-lengthening, and postoperative mobilization.8,9` ,