Abstract
Thirty-four acute traumatic dislocations in children aged 5 to 13 years, treated between 1994 and 2002, were reviewed retrospectively. All injuries were caused by a fall. Two injuries were compound. Two children had ulnar nerve injuries, one a radial nerve injury, and one median nerve and brachial artery injury. Posterolateral dislocations were seen in 22 children, posteromedial in eight, posterior in one, anteromedial in two and anterolateral in one. Pure dislocations occurred in eight children and 26 had associated elbow injuries, including 11 medial epicondyle, five lateral mass, one olecranon, one radial head and eight combined injuries. In the combined group, six children had associated fractures and two had divergent dislocation of the proximal radio-ulnar joint. Twenty required open reduction. The injury was initially missed in eight.
The child with vascular and median nerve injury had not recovered by four months. Among the others, at follow-up of 4 to 48 months 22 results were excellent to good, 10 fair and one poor. Complications included pseudarthrosis of the medial epicondyle in one child and loss of flexion and rotation of 10° to 30° in 15. Radial and ulnar nerve injuries recovered. A high index of suspicion, good clinical examination and compared radiographs are recommended to avoid missed injuries.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
