Résultats du traitement chirurgical des luxations anciennes du coude

Abstract

Introduction:
Neglected elbow dislocations are defined as dislocations that remain unreduced within three weeks of trauma. These injuries impair elbow function and treatment remains difficult.
Objective:
The aim of this work was to evaluate the functional outcome of surgical treatment of old elbow dislocations. The hypothesis was that bloody reduction coupled with lengthening of the tricipital tendon by a VY plasty significantly improved the range of motion of the elbow.
Patients and Method:
This was a retrospective study of a series of ten old elbow dislocations in ten patients operated on from 1 st January 1993 t o December 31st 2021. The mean preoperative flexion was 26.5° with extremes of 0 and 45°. The average preoperative extension was 12° with extremes of 45 and 0°. All patients were operated on by a single surgeon. The posterior transtricipital approach was used in all patients. Bloody reduction associated with tricipital tendon lengthening by a VY
plasty was performed in all patients. The parameters studied were surgery related complications, mobility, stability, pain, and elbow function. A statistical relat ionship was sought using Student's t test for a matched series between certain variables
complications related to surgery, preoperative mobility, postoperati ve stability ) and the functional outcome of the elbow after treatment (amplitude gain). The signif icance level was p<5% with a 95% confidence interval.
Results:
At the last recoil, the mean flexion was 130° with extremes of 110 and 140°. Mean extension was 16° with extremes of 40 and 0°. The mean flexion extension range of motion was 114° with extrem es of 90 and 140°. No instability was observed.
One case of paresis in the ulnar nerve territory and one case of postoperative sepsis were noted. Pain was absent in all patients. The result was excellent in 03 cases and good in 07 cases according to the Ma yo Clinic Elbow Performance Index. The results confirmed the hypothesis
Conclusion:
The treatment of neglected elbow dislocations is difficult because of the accompanying triceps retraction. VY lengthening of the tricipital tendon improves the range of mot ion of the elbow.