A dislocated elbow is considered neglected if it has been lying unreduced for three weeks or more. However, the chance for closed reduction is low even with traction if elbow has not been reduced for seven days.
There are many problems with a neglected elbow. Longer the elbow remains dislocated, more severe are the changes.
When the elbow remains out , the soft tissue starts getting contracted. This involves joint capsules, ligaments and other structures. This leads to contracture of the joint. In addition, there is shortening of triceps fibers leading to contractures of the triceps muscle.
Becasue of these contractures, the dislocated elbow can not be reeduced by closed methods after sometime. To reduce this elbow joint, all soft tissue encapsulating the joint must be released including stripping the capsule and ligaments both anteriorly and posteriorly. The triceps tendon must be lengthened and a temporary fixation is used to hold the reduced elbow in position till joint becomes stable on its own.
Inspite of every hazard, this joint must be reduced regardless the time that has passed after the dislocation.
There are many variations of the treatment including the use of gadget but the basic procedure remains same. This was first described by Speed and is known by the name of Speed’s procedure. For temporary fixations people use kwires, hinged external fixator and illizarov external fixator.
After soft tissues have healed, the joint is put on mobilisation exercises.
Popularity: 5% [?]
Related posts:
Join Discussions