Elbow dislocation in children. A retrospective study


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A Master's thesis.
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Master (thesis) (master)
Elbow dislocation in children. A retrospective study
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Université de Lausanne, Faculté de biologie et médecine
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Traumatic elbow dislocations are rare in children but first among all pediatric joint dislocations, and represent about 3%- 6% of all elbow injuries [1]. They occur most frequently around 10 years of age [1, 2]. The outcome is good most of the time with full recovery of elbow function. Complications are rare but include vascular and nervous injuries [3].
The classification of the type of dislocation is referred to the position of the proximal radio-ulnar joint with regards to the distal part of the humerus [1]. The dislocation can be posterior, anterior, medial or lateral, and rarely divergent or convergent [1].
The most common dislocation is posterior and an associated fracture is described in 50- 70% of the cases [4,5].
A fracture of the medial epicondyle, also named epitrochlea, occurs in 30-40% of elbow dislocations [1, 5-7].
Diagnosis concerning an eventual fracture can be difficult because of the occurrence of the ossification centers and their subsequent fusion [4, 5, 7]. The first ossification center to appear is the capitellum, at the age of one or two. Then follows the radial head between two and four years of age, the medial epicondyle at four to six years, the trochlea at nine to ten years with the olecranon from nine to eleven years and finally the lateral and then medial epicondyle at ten to twelve years [4].
Most of the time the pediatric elbow is incompletely ossified when the injury occurs. Recognizing the severity of the injury requires a high index of suspicion especially with regards to treatment [8].
There is ample descriptive literature focusing on different types of dislocation with and without concomitant fractures [1, 7, 9], but the relationship between problems encountered during reduction, type of dislocation and long-term outcome are not yet clearly defined.
The aims of this study were to identify various factors influencing the outcome of children who suffered an elbow dislocation.
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07/09/2015 9:35
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20/08/2019 17:22
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