Primary ligament repair in unstable elbow dislocations: a case report

Abstract

The second most commonly affected joint, when it comes to joint dislocations, is the elbow joint. These injuries can usually be treated non surgically, but the complexity of the injury can increase chronic pain and instability requiring surgical intervention. There isn’t enough evidence-based recommendation on the ideal treatment approach in acute elbow dislocations, hence, we bring forth a case report on the same. A 54-year-old male presented with a left elbow dislocation from a road traffic accident experiencing a fall on an outstretched hand and elbow. The patient complained of pain and restricted movements of the left elbow, scoring a 7 out of 10 on the Visual Analogue Scale. Examination confirmed restricted movement and tenderness along with paraesthesia in the region of the left ulnar nerve supply. Vascular integrity was maintained distal to the injury. Imaging showed closed postero-lateral elbow dislocation. Closed reduction under anesthesia was performed which revealed joint instability, leading to the soft tissue surgical repair along with complete elbow reduction. A medial approach for repair of medial ligament and lateral approach for repair of lateral ligament complex and anterior capsule repair was undertaken. Four-week follow-up revealed to have restored range of motion at the elbow joint with significant improvements in joint stability. An ideal treatment approach to elbow dislocations has yet to be decided upon based on the literature. However, common consensus dictates that simple elbow dislocations with joint instabilities warrant surgical intervention to prevent chronic joint instabilities and recurrent dislocations.