SummaryOpen elbow dislocations with vascular injury are rare injuries and they most commonly occur after a fall from a high or in sports accidents. Close anatomic proximity of the joint to the neurovascular structures put them at risk of concomitant injury. The aim of this paper is to present the method of treatment of this severe injury.Herein we present a case of a female patient, 43 years old. She had suffered an open elbow dislocation with vascular injury as a result of a fall from the height of 1.5 meters. Seven hours after sustaining the injury and short preoperative preparation, reposition of the elbow, reconstruction of the vascular injury, adequate surgical treatment of the wound and external fixation of the elbow with the Mitković type external fixator were performed under general anesthesia. Four weeks after elbow stabilization with the external fixation, the external fixator was removed. The neurovascular status and final functional result of the treatment after six mounts were good.Urgent reposition, artery and vein reconstruction, and external fixation are essential in achieving good results in patients with open cubital dislocation accompanied with vascular injury. The Mitković type external fixator provides fast and stable fixation of the elbow after reposition and good conditions for wound care.
References
1.
Platz A, Heinzelmann M, Ertel W, Trentz O. Posterior Elbow Dislocation with Associated Vascular Injury after Blunt Trauma. The Journal of Trauma: Injury, Infection, and Critical Care. 1999;46(5):948–50.
2.
Ayel JE, Bonnevialle N, Lafosse JM, Pidhorz L, Al Homsy M, Mansat P, et al. Acute elbow dislocation with arterial rupture. Analysis of nine cases. Orthopaedics & Traumatology: Surgery & Research. 2009;95(5):343–51.
3.
Sparks SR, DeLaRosa J, Bergan JJ, Hoyt DB, Owens EL. Arterial Injury in Uncomplicated Upper Extremity Dislocations. Annals of Vascular Surgery. 2000;14(2):110–3.
4.
Hildebrand KA, Patterson SD, King GJW. ACUTE ELBOW DISLOCATIONS. Orthopedic Clinics of North America. 1999;30(1):63–79.
5.
Slowik GM, Fitzimmons M, Rayhack JM. Closed Elbow Dislocation and Brachial Artery Damage. Journal of Orthopaedic Trauma. 1993;7(6):558–61.
6.
Seidman GD, Koerner PA. Brachial Artery Rupture Associated with Closed Posterior Elbow Dislocation. The Journal of Trauma: Injury, Infection, and Critical Care. 1995;38(2):318–21.
7.
Slowik GM, Fitzimmons M, Rayhack JM. Closed Elbow Dislocation and Brachial Artery Damage. Journal of Orthopaedic Trauma. 1993;7(6):558–61.
8.
Howard AC, Cooper JC, Welsh CL. Transection of the brachial artery complicating closed posterior dislocation of the elbow. Injury. 1991;22(3):240–2.
9.
Taub PJ, Giannikis G, Shen HY, Kim U. Brachial Artery Transection Following Closed Elbow Dislocation. The Journal of Trauma: Injury, Infection, and Critical Care. 1999;47(1):176–8.
10.
Mehlhoff TL, Noble PC, Bennett JB, Tullos HS. Simple dislocation of the elbow in the adult. Results after closed treatment. The Journal of Bone & Joint Surgery. 1988;70(2):244–9.
11.
Josefsson PO, Gentz CF, Johnell O, Wendeberg B. Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. A prospective randomized study. The Journal of Bone & Joint Surgery. 1987;69(4):605–8.
12.
Josefsson PO, Nilsson BE. Incidence of elbow dislocation. Acta Orthopaedica Scandinavica. 1986;57(6):537–8.
13.
Endean ED, Veldenz HC, Schwarcz TH, Hyde GL. Recognition of arterial injury in elbow dislocation. Journal of Vascular Surgery. 1992;16(3):402–6.
14.
Endean ED, Veldenz HC, Schwarcz TH, Hyde GL. Recognition of arterial injury in elbow dislocation. Journal of Vascular Surgery. 1992;16(3):402–6.
15.
Grimer R, Brooks S. Brachial artery damage accompanying closed posterior dislocation of the elbow. The Journal of Bone and Joint Surgery British volume. 1985;67-B(3):378–81.
16.
Seidman GD, Koerner PA. Brachial Artery Rupture Associated with Closed Posterior Elbow Dislocation. The Journal of Trauma: Injury, Infection, and Critical Care. 1995;38(2):318–21.
17.
Lasanianos N, Garnavos C. An Unusual Case of Elbow Dislocation. Orthopedics. 2008;31(8):806–806.
18.
Bonnevialle P, Chaufour X, Loustau O, Mansat P, Pidhorz L, Mansat M. Luxations traumatiques du genou associées à une interruption de l’artère poplitée. Revue de Chirurgie Orthopédique et Réparatrice de l’Appareil Moteur. 2006;92(8):768–77.
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