Published: 2020-11-27

Open reduction, triceps lengthening, and collateral ligaments reconstruction in neglected elbow dislocation: a case report

Henry Tirtosuharto, Made Bramantya Karna, Anak Agung Gde Yuda Asmara, Putu Feryawan Meregawa


Neglected elbow dislocations are common in developing countries. Neglected elbow dislocation leads to retraction of triceps muscles and collateral ligaments. This cause limitation of range of movement that is inadequate for the activities of daily living. A 48 years old man presented with stiffness on the left elbow. He fell down with arm in extension position 8 months prior to admission and was treated by a traditional bonesetter before seeking medical treatment. Active ROM of the left elbow was limited to 15ᵒ during flexion. The patient diagnosed as left elbow contracture due to neglected left elbow dislocation. Open reduction, MCL-LCL reconstruction and triceps lengthening was performed. Left elbow ROM was improved and MEPI score was good on 5 months evaluation. Open reduction surgery was done to avoid the risk of fracture or articular surface damage. The posterior approach provides good exposure to the retracted posterior structures and give easier access to perform V-Y plasty used for triceps lengthening. Collateral ligaments repair provides immediate stability and give better functional results. Docking technique was used for collateral ligaments repair using fascia lata tendon graft. Immobilization and physical rehabilitation are done to improve elbow joints range of movement. Open reduction surgery, triceps lengthening and collateral ligaments reconstruction using tendon graft from tensor fascia lata give satisfactory outcome for elbow contracture due to neglected left elbow dislocation.


Neglected elbow dislocation, Triceps lengthening, Collateral ligaments reconstruction

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Fornalski S, Gupta R, Lee TQ. Anatomy and biomechanics of the elbow joint. Sports Med Arthrosc. Sports Med Arthrosc Rev. 2003;11(1):1-9.

Ivo R, Mader K, Dargel J, Pennig D. Treatment of chronically unreduced complex dislocations of the elbow. Strateg Trauma Limb Reconstr. Strategies Trauma Limb Reconstr. 2009;4(2):49-55.

Coulibaly NF, Tiemdjo H, Sane AD, Sarr YF, Ndiaye A, Ndiaye A. Posterior approach for surgical treatment of neglected elbow dislocation. Orthop Traumatol Surg Res. Orthop Traumatol Surg Res. 2012;98(5):552-8.

Kachnerkar DNI, Lakde DN, Salokhe DS. Neglected old posterior dislocation of elbow: Treatment and results of open reduction. Int J Orthop Sci. 2017;3(3):1062-6.

Pundkar GN, Sonar SB, Kulkarni OP. A Case of 3-month-old Neglected Elbow Dislocation Managed by Open Reduction and Cruciate Ligament Reconstruction Using Tendon Graft. 2017;7(4):58-60.

Kodde IF, Van Rijn J, Van den Bekerom MPJ, Eygendaal D. Surgical treatment of post-traumatic elbow stiffness: A systematic review. J Shoulder and Elbow Sur. 2013;22(4):574-80.

Elzohairy MM. Neglected posterior dislocation of the elbow. Injury. 2009;40(2):197-200.

Kapukaya A, Ucar BY, Gem M. Open reduction and Kirschner wire fixation with triceps lengthening for neglected elbow dislocations. J Orthop Surg (Hong Kong). 2013;21(2):178-81.

Yazdi HR, Qomashi I, Ghorban Hoseini M. Neglected triceps tendon avulsion: case report, literature review, and a new repair method. Am J Orthop. 2012;41(7):E96-9.

Islam S, Jahangir J, Manzur RM, Chowdury AA, Tripura N, Das A. Management of neglected elbow dislocations in a setting with low clinical resources. Orthop Surg. 2012;4(3):177-81.

Camp CL, Dines JS, Voleti PB, James EW, Altchek DW. Ulnar Collateral Ligament Reconstruction of the Elbow: The Docking Technique. Arthrosc Tech. 2016;5(3):e519-23.

Derwin, KA, Aurora A, Iannotti J. Allograft Fascia Lata As an Augmentation Device for Musculoskeletal Repairs. Proceedings of the Army Science Conference. 2008.