Neglected posterior dislocation of the elbow.

The study included two adults and four children who underwent open reduction for subacute, untreated posterior dislocation of the elbow. Elbow stiffness was the main indication for surgery, and in all cases elbow movement was inadequate for the activities of daily living. Mean time from injury was 2 months and mean follow-up was 19 months. At final follow-up there were no cases of instability; according to the Mayo Elbow Performance Index(14), four outcomes were excellent, one good and one poor; the mean score improved from five preoperatively to 83 postoperatively, mean elbow flexion from 18 degrees to 93 degrees and mean pronation-supination from 20 degrees to 119 degrees. Complications included pin site infections in one case, treated by oral antibiotics and dressings, and severe degenerative changes with myositis ossificans in one case. Open reduction and V-Y muscleplasty followed by a supervised physical therapy programme can restore elbow function and stability in neglected elbow dislocations presenting up to 3 months after injury.