The relationship between elbow instability and wound healing: A report of four cases

Abstract

Introduction: The elbow is prone to wound complications due to its subcutaneous location with limited overlying connective tissue. Elbow instability may place patients at risk for wound complications, though this relationship is not well described. We present a series of four case reports from our institution to gain insight into the association of elbow instability and wound healing. Methods: Four patients who presented to our institution with elbow instability between January 2019 and September 2022 were identified by the senior author, and chart review was performed. Results: Patients A and B presented to our clinic with synovial cutaneous fistulas (SCFs) after undergoing elbow surgery. It was only after their underlying elbow instability was addressed that their wounds fully healed. Patients C and D presented with open injuries and grossly unstable elbows placing them at high risk for wound complications. In patients C and D, preventive stabilization of their elbow instability was performed, and wound complications never occurred. Conclusion: Each of these cases emphasizes the importance of achieving elbow stability to prevent SCFs and further wound complications, though further rigorous studies are required to definitively establish a causal relationship.

Keywords

• Elbow instability
• Wound healing
• Synovial cutaneous fistula
• Case series