This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Eygendaal, D.
Right arrow Articles by Rozing, P. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Eygendaal, D.
Right arrow Articles by Rozing, P. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery 82:555 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Posterolateral Dislocation of the Elbow Joint

Relationship to Medial Instability*

D. Eygendaal, M.D.{dagger}, S. H. M. Verdegaal, M.D.{dagger}, W. R. Obermann, M.D, PH.D.{dagger}, A. B. van Vugt, M.D., PH.D.{ddagger}, R. G. Pöll, M.D., PH.D.{dagger} and P. M. Rozing, M.D., PH.D.{dagger}

Investigation performed at Leiden University Medical Center, Leiden, The Netherlands
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
{dagger}Departments of Orthopedics (D. E., S. H. M. V., R. G. P., and P. M. R.) and Radiology (W. R. O.), Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands. E-mail address for D. Eygendaal: d.eygendaal{at}wxs.nl
{ddagger}Department of Traumatology, Academic Hospital Rotterdam Dijkzigt, Dr. Molewaterplein 40, 3013 GD Rotterdam, The Netherlands.

Background: Dislocation of the elbow joint is the second most common dislocation in the upper extremity, dislocation of the shoulder being the most common. It has been reported that uncomplicated dislocation of the elbow joint may be associated with a decreased range of motion, degenerative changes in the elbow joint, ectopic calcification, or neurological deficits. As the medial collateral ligament complex can be completely disrupted during dislocation, we evaluated the association between the long-term results of treatment of simple posterolateral dislocation of the elbow and the presence of persistent medial or valgus elbow instability.

Methods: Fifty patients who had a mean age of thirty-three years (range, eighteen to fifty-eight years) had closed reduction of a posterolateral dislocation of the elbow without associated fractures. The extremity was immobilized in an above-the-elbow plaster cast for three weeks. After a mean duration of follow-up of nine years (range, six to thirteen years), forty-one patients were evaluated with an interview, a physical examination, and radiographs made while a valgus load was applied to the elbow.

Results: The average score according to the system of The Hospital for Special Surgery was 91 points (range, 49 to 100 points), and thirty-one patients described their elbow function as good or excellent. Twenty-four patients had evidence of medial instability on radiographs made while a valgus load was applied to the elbow. Twenty-one patients had signs of degeneration of the joint, and twenty-five patients had ectopic ossification. Magnetic resonance imaging combined with arthrography was performed for the first twenty patients; eight had evidence of rupture of the medial collateral ligament, seven had generalized degenerative changes of the cartilage, and four had a chondral defect of the capitellum. (The study could not be completed for the remaining patient.) Medial instability on radiographs was correlated with signs of degeneration (p = 0.001), ectopic ossification (p = 0.01), a worse score according to the system of The Hospital for Special Surgery (p = 0.002), and persistent pain (p = 0.04).

Conclusions: Posterolateral dislocation of the elbow joint can lead to persistent valgus instability that is associated with a worse overall clinical and radiographic result.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
M. R. Safran, M. H. McGarry, S. Shin, S. Han, and T. Q. Lee
Effects of Elbow Flexion and Forearm Rotation on Valgus Laxity of the Elbow
J. Bone Joint Surg. Am., September 1, 2005; 87(9): 2065 - 2074.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
J. A. Mehta and G. I. Bain
Posterolateral Rotatory Instability of the Elbow
J. Am. Acad. Ortho. Surg., November 1, 2004; 12(6): 405 - 415.
[Abstract] [Full Text] [PDF]