Treatment of Neglected Elbow Dislocation with Secondary Heterotopic Ossification

TL;DR

A patient with a neglected elbow dislocation and severe complications was successfully treated with surgery, highlighting the need for early intervention.

Contribution

Presents a novel surgical approach combining excision, reduction, and radial head arthroplasty for a complex neglected elbow dislocation.

Findings

Eighteen-month follow-up showed a stable, pain-free elbow with significant range of motion.

Surgical intervention successfully addressed heterotopic ossification and elbow dislocation.

Early diagnosis and treatment are crucial to prevent complications in neglected elbow dislocations.

Abstract

A traumatic elbow dislocation that remains unreduced for more than three weeks is considered a neglected elbow dislocation. We report a case of a patient with a neglected elbow dislocation combined with a terrible triad injury (elbow dislocation with fractures of the coronoid process and radial head). Initially, the patient was managed with three weeks of cast immobilization followed by physiotherapy. However, six months after the trauma, he presented to our clinic with severe heterotopic ossification, significant pain, and nearly complete elbow stiffness. An open surgical intervention was performed, involving excision of the heterotopic bone, reduction in the dislocation, and suturing of the anterior capsule to the coronoid process. Given the irreparable fracture of the radial head, radial head arthroplasty was also performed. At 18-month follow-up, the elbow was stable and pain-free, with flexion–extension of 80°, pronation of 85°, and supination of 80°. This case underscores the critical importance of early diagnosis and intervention to prevent long-term complications in neglected elbow dislocations.

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