Background. Anterior elbow fracture dislocation is rare, especially in paediatric age group. Of the reported cases to date, three-quarter were posterior dislocation of the elbow. Anterior elbow dislocation is rarely reported, with incidence of only 2%. Clinical case. A 6-year-old girl presented to casualty with left elbow deformity and pain after she tripped and fell in the toilet. Ulnar clawing was present with reduced sensation over ulnar nerve distribution. No wound was found, distal pulses and circulation were good. The X-rays showed anterior dislocation of the left elbow with olecranon fracture. Closed manual reduction was attempted but failed. Open reduction and percutaneous K-wire insertion under general anaesthesia was performed. Medial approach of the elbow was done. Intra-operatively ulnar nerve was found impinged by the distal ulnar fragment but was in continuity. The transverse olecranon fracture was fixed with two K-wires and the radial head was reduced. Ulnar nerve was mobilised until tension-free. Ulnar collateral ligament was repaired. The elbow was immobilised with a splint. Ulnar claw was resolved at 2 weeks. The fracture heals and the K-wires were removed at 6 weeks. At 8 weeks, range of movement of the elbow was full. The elbow was stable in varus and valgus. Discussion. Anterior elbow dislocation is a high energy trauma and one should be cautious of neurovascular injury. There was no clear recommendation in the literature regarding surgical approach. We chose medial approach of the elbow for ulnar nerve exploration and olecranon fixation. Conclusion. This rare injury should be treated with high index of suspicious. Surgical approach should be tailored individually according to the instability of the elbow joint and neurovascular status, as in this case was the posteromedial instability associated with ulnar nerve palsy.

Comprehensive care towards geriatric health can be sustained by having good knowledge and attitude among the providers. Hence, this research aims to measure the knowledge and attitude of the final year medical students towards geriatric health and determine the associated factors. A cross-sectional study was conducted among the students using structured questionnaires of Geriatric-Attitude-Scale and Palmore-Facts-on-Aging-Quiz was used. Data was analysed using Mann Whitney U test, Chi square test and Spearman correlation coefficient analysis for the association between the score and studied variables. Median score of students’ knowledges is at 14.00 (IQR 13.00) and mean score for attitude is 48.52 (+5.53) respectively. Place of residence (P= 0.01) and presence of grandparents (P= 0.04) were the significant factors that affected knowledge of students towards geriatrics while number of siblings (P= 0.05) influenced attitudes of students towards geriatrics. Improvement of current geriatric curriculum should be done with more refined implementation of gerontology course in the basic medical learning.