Results of Open Reduction and V-Y Triceps Plasty of Old Unreduced Elbow Dislocations in 38 Patients with Severe Extension Deformity

Nuradeen Altine Aliyu *

Department of Orthopaedics and Trauma, Usmanu Dan Fodio University Teaching Hospital, Sokoto, Nigeria.

Ahmad Kamaluddeen

Arthroplasty/Arthroscopy Unit, National Orthopaedic Hospital, Dala, Kano, Nigeria.

*Author to whom correspondence should be addressed.


Introduction:  Old unreduced posterior elbow dislocation is fairly common in developing countries due to delay in presentation after initial intervention by the traditional bone setters. This poses a huge management challenge for orthopaedic surgeons because of the accompanying triceps retraction. In this article, we report outcome of treatment of old unreduced elbow dislocations with severe extension deformities using open reduction with V-Y tricepsplasty through the posterior approach. 

Methodology: This was a retrospective study of/involving 38 patients operated with pld unreduced posterior elbow dislocations from August 2015 to March 2023. The presentation was within 3 to 18 months from the injury time at the orthopaedic hospital Wamakko, Sokoto, Nigeria. There were 31 males, and 7 females with mean age of 32 (range 18 to 64years). The mean elbow flexion was 11° (range was 5° to 45°) before the procedure. Our management protocol was the use of posterior elbow joint approach and Speed Technique of V-Y plasty for triceps lengthening and stabilizing the reduced joint with kirschner (K) wire. 

Results: The mean patients’ follow up was 21 (range 16 to 26 months). The average Mayo elbow performance index (MEPI) score on admission was 54, while the average MEPI score after the procedure was 88,with 29 (76 %) patients having excellent result, 3 (8%) with good result, 5 (13%) with fair, and 1 (3)% with poor results. On the scale of pain, the mean score was 42; the mean elbow flexion was 11° (range 5° to 45°) before the procedure, and after surgery the mean score was 118° (range 45° to 135°). Complications were 5 cases of ulnar nerve neuropraxia that all resolved within first 3 months postoperatively. Two cases of heterotopic ossifications and 1 postoperative elbow stiffness all significantly improved following rehabilitation therapy.

Conclusion: The functional outcome of old unreduced elbow dislocations presenting with severe extension deformity can be satisfactory following open reduction and V-Y Tricepsplasty.

Keywords: Old unreduced elbow dislocation, open reduction, V-Y plasty, K wire

How to Cite

Aliyu, Nuradeen Altine, and Ahmad Kamaluddeen. 2024. “Results of Open Reduction and V-Y Triceps Plasty of Old Unreduced Elbow Dislocations in 38 Patients With Severe Extension Deformity”. Asian Journal of Orthopaedic Research 7 (2):71-79.


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Naidoo KS. Unreduced posterior dislocations of the elbow. J Bone Joint Surg Br. 1982;64:603–606.

Freeman III BL. Old unreduced dislocations. In: AH Crenshaw, ed. Campbell's Operative Orthopaedics, 9th edn. St. Louis: Mosby. 1998;2673–2674.

Mehta S, Sud A, Tiwari A, et al. Open reduction for late-presenting posterior dislocation of the elbow. J Orthop Surg. 2007;15:15–21.

Jupiter JB. Trauma to the adult elbow fractures of the distal humerus. In: BD Browner, AM Levine, PG Trafton, eds. Skeletal Trauma. Philadelphia: Saunders. 1992;1141.

King GJW. The complex dislocations of the elbow. In: A Celli, L Celli, BF Morrey, eds. Treatment of Elbow Lesions. Milan: Springer. 2007;1033.

DeLee JC, Green DP, Wilkins KE. Fractures and dislocations of the elbow. In: CA Rockwood, DP Green, eds. Fractures in Adults, 2nd edn. Philadelphia: Lippincott, 1984;559.

Linscheid RL, Wheeler DK. Elbow dislocations. JAMA. 1965;194:1171– 1176.

Rockwood CA. Treatment of old unreduced posterior dislocation of elbow. In: Rockwood CA, editor. Rockwood and Green’s fracture in adults. 4th ed. Philadelphia: Lippincot-Raven. 1996;I:975-6.

Islam S, Jahangir J, Manzur RM, Chowdury AAA, Tripura N, das A. Management of neglected elbow dislocations in a setting with low clinical resources. Orthop Surg. 2012;4(3):177-181.

Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal function of elbow motion. J Bone Joint Surg Am. 1981;63:872-7.

Naidoo KS. Unreduced posterior dislocation of the elbow. J Bone Joint Surg Br. 1982;64:603-6.

Bruce C, Laing P, Dorang J, Kleneman L. Unreduced dislocation of the elbow: Case report and review of literature. J Trauma. 1993;35:962-5.

Allende G, Freyetes M. Old dislocation of the elbow. J Bone Joint Surg. 1944; 26:691-706.

Longo UG, Franceschi F, Loppini M, Maffulli N, Denaro V. Rating systems for evaluation of the elbow. British Medical Bulletin. 2008;87(1):131-61.

Coulibaly NF, Tiemdjo H, Sane AD, Sarr YF, Ndiaye A, Seye S. Posterior approach for surgical treatment of neglected elbow dislocation. Orthopaedics & Traumatology: Surgery & Research. 2012;98(5):552-8.

Panteli M, Pountos I, Kanakaris NK, Tosounidis TH, Giannoudis PV. Cost analysis and outcomes of simple elbow dislocations. World Journal of Orthopedics. 2015;6(7):513.

Morrey B, Sanchez-Sotelo J, Morrey M. Elbow Stiffness: Basic Science and Overview dislocations. In: The Elbow and Its Disorders. 5th éd. Philadelphia: Elsevier Inc. 2018;529-34.

Ekere AU, Echem RC. Complications of fracture and dislocation treatment by traditional bone setters: a private practice experience. Nigerian Health Journal. 2011;11(2):59-66.

Matelenok YM. Treatment of neglected complex dislocations in the elbow joint (clinical case). Orthopaedics, Traumatology & Prosthetics/Ortopediia, Traumatologiia i Protezirovaniie. 2023;(3).

Salihu MN, Arojuraye SA, Alabi AI, Mustapha IU, Okoh N, Ayeni FB. Old unreduced elbow dislocation: Patients’ perspectives on outcome of open reduction. The Surgeon. 2021;19(2):87-92.

Clarke DD, Ward P, Bartle C, Truman W. In-depth study of motorcycle accidents. Road Safety Research Rep. 2004;54.

Pal CP, Mittal V, Dinkar KS, Kapoor R, Gupta M. Neglected posterior dislocation of elbow: A review. Journal of Clinical Orthopaedics and Trauma. 2021;18:100-4.

Kachnerkar NI, Lakde N, Salokhe S. Neglected old posterior dislocation of elbow: treatment and results of open reduction. Int J Orthop Sci. 2017;3(3o):1062-6.

Nicola L, Birhanu A, Aselefech G, Giovanni M. Outcome of open reduction for the neglected posterior dislocation of the elbow in a low-to-middle income country. Tropical Doctor. 2016;46(2):96-100.

Islam MS, Jahangir J, Manzur RM, Chowdury AA, Tripura N, das A. Management of neglected elbow dislocations in a setting with low clinical resources. Orthopaedic Surgery. 2012;4(3):177-81.

Atwan Y, Abdulla I, Grewal R, Faber KJ, King GJ, Athwal GS. Indomethacin for heterotopic ossification prophylaxis following surgical treatment of elbow trauma: A randomized controlled trial. Journal of Shoulder and Elbow Surgery. 2023;32(6):1242-8.

Tangtiphaiboontana J, Agel J, Beingessner D, Hébert-Davies J. Prolonged dislocation and delay to surgery are associated with higher rates of heterotopic ossification in operatively treated terrible triad injuries. JSES international. 2020;4(2):238-41.

Potini VC, Ogunro S, Henry PD, Ahmed I, Tan V. Complications associated with hinged external fixation for chronic elbow dislocations. The Journal of Hand Surgery. 2015;40(4):730-7.

AyADi D, ETiEnnE P, Burny F, SCHuinD F. Results of open arthrolysis for elbow stiffness. A series of 22 cases. Acta Orthop Belg. 2011;77(4):453-7.

Kapukaya A, Ucar BY, Gem M. Open reduction and Kirschner wire fixation with triceps lengthening for neglected elbow dislocations. Journal of Orthopaedic Surgery. 2013;21(2):178-81.

Iordens GI, Den Hartog D, Van Lieshout EM, Tuinebreijer WE, De Haan J, Patka P, Verhofstad MH, Schep NW, Collaborative DE. Good functional recovery of complex elbow dislocations treated with hinged external fixation: a multicenter prospective study. Clinical Orthopaedics and Related Research®. 2015;473(4):1451-61.

Sumarwoto T, Hadinoto SA, Aprilya D, Bayudono S, Siswanto T. Functional outcomes of neglected elbow dislocation treated with double approach surgery. Orthopedic Research and Reviews. 2023:175-81.