Irreducible Elbow Dislocation Associated with Hill-Sachs-like Lesion over the Capitellum
10.5397/cise.2019.22.1.37
- Author:
Hung Kai WENG
1
;
Wei Lun CHANG
;
Ming Long YEH
;
Wei Ren SU
;
Kai Lan HSU
Author Information
1. Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. dulendulen@gmail.com
- Publication Type:Case Report
- Keywords:
Hill-Sachs lesions;
Fracture dislocation;
Avulsion fracture
- MeSH:
Aged;
Dislocations;
Elbow;
Emergency Service, Hospital;
Female;
Follow-Up Studies;
Forearm;
Humans;
Humeral Head;
Joints;
Range of Motion, Articular;
Traction
- From:Clinics in Shoulder and Elbow
2019;22(1):37-39
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
