• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.181-186
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• 2005

An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.175-175
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• 2007

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.37-39
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• 2019

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.266-269
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• 2010

Purpose: We report case of neglected elbow dislocation for three years. Material and method: A 45 years old female patient presented with neglected elbow dislocation for three years. Since the patient had contracture in both lateral and medial collateral ligament of elbow, dissection was done. After total separation of posterior articular capsule and incision of anterior articular capsule, by manual manipulation, reduction of radiohumeral and ulnohumeral joints were obtained. We applied modified Morrey type hinged external fixation in the elbow and done early elbow exercise. Result and Conclusion: Since we have experienced a satisfactory result in the case with neglected elbow dislocation for 3 years by using open reduction and hinged external fixation, we report it with the literature.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.236-241
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• 1998

Recurrent dislocation of elbow joint occurs relatively rarely by the injury of the collateral ligament which contributes elbow joint stability. Among them, posterolateral rotatory instability occurs by the injury to the lateral ulnar collateral ligament. We experienced a case of recurrent dislocation of elbow joint due to posterolateral rotatory instability. We treated operatively with lateral ulnar collateral ligament reconstruction using the palmaris longus tendon by technique of Nestor et al. We report it with literature analysis.

• Clinics in Shoulder and Elbow
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• v.22 no.2
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• pp.93-99
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• 2019

Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was $164.6^{\circ}$, external rotation at the side was $61.2^{\circ}$ and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.21-21
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• 2007

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.27-30
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• 2020

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.209-215
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• 2016

Background: The purpose of this study was to identify the clinical and radiological outcomes of hook plate fixation for lateral end fracture of the clavicle and acromioclavicular dislocation. Methods: There were a total of 20 cases with lateral end fracture of the clavicle and 16 cases with acromioclavicular dislocation. All patients were evaluated for range of motion, functional score by using Constant score, and American Shoulder and Elbow Surgeons shoulder index at just before implant removal and at final follow-up. Coracoclavicular distance was measured in acromioclavicular dislocation and bony union was evaluated in the lateral end fracture of the clavicle. Results: The clinical outcomes and range of motion were increased at the final follow-up compared with just before implant removal in both the lateral end fracture of the clavicle and acromioclavicular dislocation. In acromioclavicular dislocation, all cases-except one-showed maintenance of reduction after implant removal. Moreover, in the lateral end fracture of the clavicle, all cases-except one-showed bony union. Conclusions: Hook plate fixation in the lateral end fracture of the clavicle and acromioclavicular dislocation resulted in good clinical and radiological results.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.234-239
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• 2018

Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.