FUNCTIONAL OUTCOME OF NEGLECTED POSTERIOR ELBOW DISLOCATION MANAGED SURGICALLY BY OPEN REDUCTION IN A NORTH-EAST TERTIARY CENTRE OF INDIA

Introduction: Neglected posterior elbow dislocation is common in developing countries. Various treatment methods have been described. Considering the lack of facilities and cost constraints in developing countries, the treatment options are limited. The aim of the study is to evaluate the functional outcome of neglected posterior elbow dislocation managed surgically by open reduction and internal fixation with trans-olecranon Kirschner wire with or without triceps lengthening. Methods: In a retrospective study from July 2020 to June 2022, 7 patients with neglected posterior elbow dislocation were treated in our hospital with mean follow-up of 11.14 months. The Mayo Elbow Performance Index (MEPI) was used to assess subjective, objective, and functional characteristics before and after operation. Results: The mean age of 7 patients (4-males and 3-females) was 26 years. The most common mode of injury was fall with mean time interval between injury and surgery of 8.14 weeks. The mean duration of surgery was 75.71 minutes. The mean pre-operative elbow flexion was 17.86º and post-operative elbow flexion was 92.14º. The mean pre-operative elbow PS (pronation-supination) range was 17.14º and post-operative elbow PS range was 109.29º. The mean pre-operative MEPI was 5 and post-operative MEPI was 77.86. Five patients had satisfactory results (2- Excellent and 3- Good) and 2 patients had unsatisfactory results (1- Fair and 1- Poor). Conclusion: Considering all limitations in developing countries, open reduction with or without triceps lengthening followed by post-operative range of motion exercises is still the mainstay treatment to gain a functional arc of motion in the management of neglected posterior elbow dislocation.