Divergent elbow dislocation with radial shaft fracture, distal ulnar deformation, and distal radioulnar joint instability: an unclassifiable Monteggia variant

Laratta, Joseph L.; Yoon, Richard S.; Frank, M; Koury, Kenneth L.; Donegan, Derek J.; Liporace, Frank A.

doi:10.1007/s10195-013-0239-x

Cited by 9 publications

(7 citation statements)

References 16 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%

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%

Traumatic divergent dislocation of the elbow in the adults

Gong

Wang

Jiang

et al. 2023

International Orthopaedics (SICOT)

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“…Injuries to the annular ligament and medial collateral ligament were common soft-tissue complications. Although several cases were treated with closed reduction, 10 cases required open surgery to treat fractures or dislocation [9][10][11][12]16,25,27,31,33,34 . Annular ligament, capsule, and bone fragment from the fracture site were commonly listed as reduction-inhibitory factors.…”

Section: Discussionmentioning

confidence: 99%

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

Onode

Takamatsu

Kuroda

et al. 2021

JBJS Case Connector

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Case: A 32-year-old man with Ehlers–Danlos syndrome (EDS) fell while snowboarding and injured his right elbow. Radiography revealed a posterior dislocation of the elbow and a proximal radioulnar joint dislocation. A diagnosis of transverse divergent dislocation of the elbow was established. Open reduction and repair of the annular ligament, anterior oblique ligament, and capsule was performed with good clinical results. Conclusion: This is the first report of divergent dislocation of the elbow in an adult with EDS. Dislocation occurred without a fracture that required open reduction and internal fixation. The presence of soft-tissue fragility, hyperextension, and joint laxity peculiar to EDS are likely contributing factors to this phenomenon.

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“…Lastly, one case report most closely resembled the variant discussed in our paper. Laratta et al described a posterior ulno-humeral dislocation with anterior radial head dislocation, with an associated radial shaft fracture, as well as disruption of the DRUJ [17] . Ultimately, after a thorough review of the literature, our cases unique pattern of a posterior ulno-humeral and radio-capitellar joint dislocation, and radial shaft fracture without any fracture or deformation to the ulna has not been discussed before to our knowledge.…”

Section: Discussionmentioning

confidence: 99%