Elbow Dislocation

• 3-6% of all elbow injuries• Peak: 13-14 yrs after closure of physes• High association with the following fractures– Medial epicondyle– Coronoid– Radial head and neck

• Modified hinge joint• Very stable– Joint congruity– Opposing tension of triceps and flexors– Ligaments• Most important: Medial Collateral Ligament

Mechanism of Injury

• Fall on an outstretched hand o elbow– Causes unlocking of the olceranon from the

trochlea + translation of the articular surfaces• 2 types of dislocation– Posterior– Anterior

Malunion Discussion

Malunion

• Described to be a fractured bone that did not heal in an anatomic position

• Bone may have: – Angulated– Rotated out of position– Overlapped with another bone

• Caused by: – Inadequate immobilization– Misalignment– Premature removal of an immobilizer

Non-union

• A fracture that did not heal after a span of several months

• Caused by:– Overdistraction– Excessive motion – Inadequate immobilization

Risk factors for poor fracture healing

• Smoking• Excessive alcohol intake• Malnutrion• Diabetes• NSAID, corticosteroids• Anticonvulsants and Thyroid Hormone

Replacement

Presentation

• History– A fracture that was not brought to a physician– Deformity– Pain, edema– Instability

• PE– Deformity and tenderness