Residual increased valgus stress angulation and posterolateral rotatory translation after simple elbow dislocation.

ABSTRACT

PURPOSE: Purpose of this study was to evaluate increased valgus stress angulation and increased posterolateral rotatory translation after simple elbow dislocation and the associated clinical instability. METHODS: Ten patients [three women, seven men; mean age 38 ± 11 years; mean follow-up 54 months (median 47 months; range 23-111 months)] with conservatively treated simple elbow dislocations were included into this study. The elbow function was graded by using the subjective elbow value (SEV), the Oxford Elbow Score (OES), the Mayo Elbow Performance Score (MEPS), as well as the DASH Score. Range of motion (ROM) and clinical signs of valgus and posterolateral rotatory instability (PLRI) were evaluated. Additionally, in all patients sonographic and fluoroscopic evaluation of valgus stress angulation and posterolateral rotatory translation was performed. RESULTS: Functional scores showed excellent to good results in all patients (SEV 92 %; OES mean 44 ± 5 points; MES mean 91 ± 9 points; DASH Score mean, 4 ± 4 points). The ROM did not reveal any significant differences compared to the non-affected side. Overall, three patients presented signs of clinical instability (valgus instability n = 1; PLRI n = 2). Sonographically, a slightly but not significantly increased valgus stress angulation in comparison with the non-affected side was measured (n.s.). The posterolateral rotatory translation was significantly increased compared to the non-affected side (p < 0.05). In this context, sonographically, four of ten patients revealed a valgus stress angulation and seven of ten patients a posterolateral rotatory translation more than 50 % compared to the non-affected. In four patients an increased valgus stress angulation and in four patients an increased posterolateral rotatory translation could be seen fluoroscopically. CONCLUSION: Patients after conservatively treated simple elbow dislocations show good clinical and functional results. However, a sufficient anatomical ligamentary heeling does not exist. LEVEL OF EVIDENCE IV.