Elbow: Trauma

Pediatric Elbow Dislocation Associated with Proximal Radioulnar Translocation: A Report of Three Cases and a Review of the Literature

Combourieu B, Thevenin-Lemoine C, Abelin-Genevois K, et al (Armand Trousseau Hosp, Paris, France) J Bone Joint Surg Am 92:1780-1785, 2010^§

Abstract

Background

Elbow dislocation in children accounts for just 3% of elbow injuries. Only 12 cases of proximal radioulnar translocation have been reported in children. It is often misdiagnosed initially, leading to delayed treatment and a poor functional result. Three cases were reported.

Case Reports

Case 1: Girl, 6, had fallen on her right elbow and complained of a painful, swollen right elbow. No neurologic or vascular problems were found, but anteroposterior and lateral radiographs revealed proximal radioulnar dislocation of the right elbow. Closed reduction was performed with the patient placed under general anesthesia, then the arm was immobilized in a posterior splint with the forearm in neutral position and the elbow flexed at 90° for 2 months. Transient ulnar nerve palsy occurred but resolved within 6 months. Three-month assessment showed normal radiographic appearance and 20% loss of pronation. Complete range of elbow and forearm motion was regained at 1 year.

Case 2

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