elbow dislocation

Medial Epicondyle

Ossification

Apophysis appears around 7 years

Ossifies age 16 years

Normal apophysis may be some distance from shaft

- rarely may be fragmented

Aetiology

Dislocation

Indications

1.  Persistent instability despite ORIF and LCL repair

2.  Gross acute instability, not suitable for surgery

3.  Delayed treatment > 4 weeks

Acute Elbow Dislocation Management

1.  Reduction under IV / conscious sedation

- assistant applies traction in slight flexion

- second person corrects lateral displacement by manipulating olecranon medially

- flexion to 90^o

2.  Post reduction assess stability