Multiple Cantilever K-wiring Technique for Severely Comminuted Articular Fragments in Neglected Distal Humerus Fracture with Anterior Elbow Dislocation: A Case Report.

ABSTRACT

Introduction: Anterior dislocation of the elbow is comparatively less frequent and is often associated with fractures of the distal humerus. Such injuries require surgical intervention at the earliest but with the surge of COVID-19 pandemic and different protocols being followed by surgeons, such cases are getting neglected. We present a 5-week-old neglected anterior dislocation of the right elbow joint with lateral condyle and medial epicondyle humerus fracture and a unique cantilever K-wiring technique used for its treatment. Case Presentation A 30-year-old man presented with pain, deformity, and limited range of movement of his right elbow joint and a non-healing wound over the olecranon after he had a road traffic accident 5 weeks back. The patient had been initially treated in a local hospital where he tested positive for COVID-19 and was managed conservatively. Radiographs revealed lateral condyle and medial epicondyle humerus fracture and an unreduced anterior dislocation of the right elbow joint. Conclusion: Neglected fracture-dislocation of the elbow is challenging and is further complicated by comminuted fragments with loss of bone stock. A unique use of multiple Kirschner wires in a cantilever fashion provides a good fixation alternative for such cases.