Treatment of Neglected Elbow Dislocations by Z-Lengthening of the Triceps Brachii
Treatment of Neglected Elbow Dislocations by Z-Lengthening of the Triceps Brachii作者机构：Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké Cô te d’Ivoire
出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)
年 卷 期：2022年第12卷第4期
页 面：142-152页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Elbow Dislocation Neglected Triceps Plasty Posterior Approach
摘 要：Introduction: Neglected elbow dislocations are much more common in developing and underdeveloped countries. The main reason for the delay in diagnosis is that patients initially seek treatment from traditional healers. These will immobilize the elbow in extension, which will lead to the retraction of the triceps muscle and collateral ligaments. Patients and Method: We carried out a prospective study over five years (2014-2019). The study involved patients with unreduced elbow dislocation older than 21 days. All patients with a dislocated fracture and those whose x-ray showed joint fusion were not included in the study. We collected 26 patients, 20 men and 6 women with an average age of 27.5 years (17 and 45 years). The average consultation time was 8.9 months (3 - 13). The approach was posterior about 8 cm above the olecranon and 2 cm below the olecranon, the ulnar nerve was identified and isolated. The triceps tendon was cut in a Z from its myotendin junction to the beak of the olecranon, and then lengthened. Results: The patients were reviewed after a mean follow-up of 24 months (12 - 36). The Mayo Clinic’s average elbow performance index was 77.1 (60 - 85), with 19 good and 6 average results. The mean flexion was 114°(100°- 135°) and the mean extension deficit was 31.15°(10°- 55°). The average range of motion was 82.5°(60°- 120°). We did not find a correlation between the duration of the lesion and functional recovery (p 0.05). The Wilcoxon test showed that surgery significantly improved the overall range of motion of the elbow (p = 0.001). Discussion: Based on this study, open reduction with tendon lengthening should remain a treatment option regardless of the age and chronicity of the dislocation.
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