Complex Elbow Dislocation with Ipsilateral Humeral Shaft Fracture Management

A 35-year-old man, with no previous medical records, came into our casualty after being fall from height while painting, complaining of pain and swelling in his left elbow and arm. He had marked swelling over his left elbow and arm, Neurovascular status was physiological, and there were no associated wounds. The patient was advised X-ray and CT scan of elbow, shoulder with arm were obtained Plain radiographs showed humeral shaft fracture with complex elbow dislocation, CT scan showed a very rare fracture pattern of humeral shaft fracture with complex elbow dislocation with coronoid, capitellum, lateral trochlear ridge and radial head fracture. Open reduction and internal fixation with plate and screws of the humerus was initially performed, lateral Trochlear fragment was fixed with minifragment screw, capitellum is fixed with Herbert screw and cancellous screw, for unstable elbow trans Olecranon humeral k wire applied, coronoid fixation done with pull out suture, medial collateral ligament repaired with suture anchor, distal radioulnar joint was fixed with k wire. This is a very rare injury pattern and a guidance for sequence of fixation is hard to find in literature. A combination of bony and soft tissue procedures addressing individual injuries and stabilising operatively must be attempted. Complete stabilisation and early mobilisation will give optimal results in these fractures.