Divergent Dislocation of the Elbow in an Adult with Ehlers–Danlos Syndrome

Onode, Ema; Takamatsu, Kiyohito; Kuroda, Toshiro; Kazuki, Kenichi; Nakamura, Hiroaki

doi:10.2106/jbjs.cc.21.00159

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Each type in our study was demonstrated in previous literature [2][3][4][5][6]. These concomitant fracture-dislocations of the forearms further complicated the DDE in adults, which brought a considerable challenge to orthopaedic surgeons.…”

Section: Discussionsupporting

confidence: 58%

“…This evidence showed that the forearm was in a position of supination and the displaced humerus divorced the radius and ulna. Moreover, recent literature mentioned that annular ligament (AL) reconstruction should be considered due to a posterolateral dislocated radial head [6]. However, our surgeon did not find the AL damage due to the dislocated radial head during surgery.…”

Section: Discussionmentioning

confidence: 60%

“…The external fixator was removed at 6 weeks post-operative (f-g) and he has full range of motion at 18 monthly follow-up (h-k) observed with generalized swelling of the elbow, severe torsion, ulnar and radial shaft fractures, an LCL tear, and traumatic amputation of the distal aspect of the forearm and the wrist [5]. A case report revealed that a patient with Ehlers-Danlos syndrome (EDS) fell while snowboarding and developed a DDE without a fracture that required an ORIF [6]. Clinical features of this disease included soft-tissue fragility, hyperextension, and joint laxity.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic divergent dislocation of the elbow in the adults

Gong

Wang

Jiang

et al. 2023

International Orthopaedics (SICOT)

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Purpose This retrospective study aimed to investigate the clinical outcomes of DDE in adults. Methods From September 2010 to March 2020, adult patients with traumatic DDEs admitted to Beijing Chaoyang Hospital and Beijing Jishuitan Hospital were included in this study. Each patient underwent operative or conservative treatment during hospitalization. The clinical and radiological examinations were followed up. The primary outcomes included the Mayo Modified Wrist Score (MMWS), the Mayo Elbow Performance Score (MEPS), the Broberg and Morrey functional index, the Disabilities of the Arm, Shoulder and Hand (DASH) score, and the Visual Analogue Scale (VAS) score that were performed. Post-operative complications and secondary surgery details were also collected. Results Of the fourteen patients, clinical and radiographic results were reviewed at a mean of 53.2 months (18 to 110 months) postoperatively. There were 11 men and three women with an average age of 31.5 years (17 to 51 years). At the final follow-up, the average MMWS, MEPS, Broberg and Morrey functional index, and DASH scores were 91.4 points, 93.4 points, 92.6 points, and 10.7 points. The mean VAS at rest and during activities was 0.4 and 1.7 points. Two patients required a secondary procedure due to radial malalignment and elbow contracture, respectively. In addition, two patients were found degeneration. Conclusions Within the context of high-energy DDE combined with simultaneous upper limb injuries, our study recommended obtaining the mechanical benefit of the forearm ring with concentric elbow stability. Despite the various and complicated traumatic patterns of DDE, great clinical results could be acquired based on adequate surgical treatments and early rehabilitation training.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Traumatic divergent dislocation of the elbow in the adults

Gong

Wang

Jiang

et al. 2023

International Orthopaedics (SICOT)

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Recurrent Elbow Instability in a Patient With Ehlers-Danlos Syndrome Treated With Soft Tissue Reconstruction: Case Report

Rodà,

Martinelli,

Celli

et al. 2024

JSES Reviews, Reports, and Techniques

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Outcomes of orthopaedic surgery in Ehlers-Danlos syndromes: a scoping review

Schubart,

Mills,

Rodeo

et al. 2024

BMC Musculoskelet Disord

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Background Patients with Ehlers-Danlos syndromes (EDS) often experience high rates of joint subluxations and dislocations, and associated pain that may require surgical interventions. Orthopaedic surgical management is challenging in this population, and patients will often undergo multiple unsuccessful surgeries. Outcomes data specific to patients with EDS are sparse in the orthopaedic surgery literature. We conducted a scoping review to evaluate the evidence and outcomes for orthopaedic surgery specifically for the EDS population. Methods PubMed MEDLINE, Embase, The Cochrane Library, Cochrane Controlled Register of Trials (CENTRAL), CINHL, and Scopus from their inception to February 28, 2024 for all studies that reported outcomes for orthopaedic surgery in patients with EDS. Two reviewers independently determined study eligibility, rated study quality, and extracted data. Methodology followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The studies in this scoping review include Level III (retrospective cohort and case control) and Level IV (case series) evidence. Results The literature search yielded a total of 71 citations published between 1990 and 2023. All were primary studies. 38 were single case studies, 14 were case series, and 19 were retrospective cohort studies. No randomized clinical studies or systematic reviews were identified. Overall, the reported findings for the various anatomical sites and procedures indicated that surgery outcomes were inconsistent. Our review highlights the need for future research to determine whether currently established surgical approaches for various orthopaedic conditions offer long-term clinical benefit in patients with EDS. This is clearly a challenging diagnosis, and more rigorous clinical studies are required to identify optimal treatment approaches. Conclusions Our review found little evidence-based research to guide optimal surgical treatment in EDS. Established surgical techniques that have been shown to be successful in the wider orthopaedic population should be studied to determine their efficacy in the EDS population. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-024-07937-6.

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Divergent Dislocation of the Elbow in an Adult with Ehlers–Danlos Syndrome

Cited by 3 publications

References 28 publications

Traumatic divergent dislocation of the elbow in the adults

Traumatic divergent dislocation of the elbow in the adults

Recurrent Elbow Instability in a Patient With Ehlers-Danlos Syndrome Treated With Soft Tissue Reconstruction: Case Report

Outcomes of orthopaedic surgery in Ehlers-Danlos syndromes: a scoping review

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