Interposition Arthroplasty and Hinged Bar External Fixation for Neglected Fracture Dislocation Elbow: A Case Report

Introduction: Chronic elbow dislocations present significant challenges due to fibrous tissue formation and joint contractures. Early and effective intervention is critical to restore function and prevent long-term disability. Case report: We report the case of a 52-year-old female with a neglected left elbow dislocation for six months, accompanied by tingling in the left fingers. Initial injury occurred after a fall from a palm tree, leading to a diagnosis of neglected fracture dislocation of the left elbow with associated osteolytic changes and radial head dislocation. The patient underwent surgical intervention, including open reduction, internal fixation, interposition arthroplasty, and the application of a hinged external fixator. The surgery involved a posterior approach, extensive dissection to remove fibrous tissue, reduction of the fracture, fixation with screws and K-wire, and grafting with fascia lata. A hinged external fixator was applied to maintain joint stability and allow early mobilization. Post-surgery, the patient received antibiotics, analgesics, and instructions for active range of motion exercises while maintaining elbow immobilization at 90 degrees. Follow-up indicated stable fixation, controlled pain, and good distal limb function. Discussion: This case illustrates the complexities of treating chronic elbow dislocations, emphasizing the need for extensive surgical release and reconstruction. The use of a hinged external fixator facilitated early mobilization and contributed to a positive functional outcome. Early diagnosis and intervention are crucial to prevent complications and ensure successful recovery. Conclusion: Comprehensive surgical management, combined with diligent post-operative care, is essential in treating neglected elbow dislocations, underscoring the importance of early treatment to restore function and improve patient quality of life. Keywords: neglected fracture dislocation elbow, hinged external fixator, interposition arthroplasty, early mobilization, case report