The Journal of Bone and Joint Surgery, Vol 66, Issue 6 921-926, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Untreated posterior dislocation of the elbow in children
JV Fowles, MT Kassab and M Douik
Fifteen children with an untreated posterior dislocation of the elbow were
seen between 1965 and 1980. Three had a useful range of painless flexion
and were not treated by operation. Twelve had a stiff elbow and had an open
reduction between three weeks and three years after injury. The triceps was
lengthened when it prevented reduction and Kirschner wires were used when
necessary to stabilize the elbow. Complications included a transient
paralysis of the hand in one patient and myositis ossificans with a rigid
elbow in another. The length of follow-up ranged from one to six years. In
eleven patients the average range of flexion was increased fourfold, and in
all children the elbow had a useful range through 90 degrees of flexion.
Eleven children said that the function of the arm was improved. However,
four of them had been operated on within six weeks of the accident and
might have regained a functional range of movement with a short trial of
conservative therapy. We now recommend an interval of conservative
treatment for children who are seen three weeks to two months after injury.
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