X-Ray (R) Elbow. Film 1 (both view)

I got 1 case to be share with. Patient came to our casualty for review the progress after given TCA by one 0f 'THE BIG TEACHING HOSPITAL in KL' with diagnosis soft tissue injury (R) elbow. They put on back slab (R) upper limb.

Patient, 27 year old, malay, female, alleged fall down at home 1 week ago with complaint of pain associated with persistent swelling and reduce range of motion (R) elbow joint. On examination shows swelling, deformity, clinically dislocation, reduced range of motion (R) elbow joint however, no neurological deficit.

(R) elbow X-ray done shows Posterior Dislocation (R) ELbow Joint. Otherwise, no obvious fractuer seen. See film 1,2,3.

Film 2. Lateral view (R) elbow.

Film 3. AP view (R) elbow.

So, we change the diagnosis with Alleged fall down with posterior dislocation (R) elbow joint. Do you accept this case with diagnosis STI which is diagnosed by Orthopaedic MO in teaching hospital. Think!!!. Actually this case such a simple dislocation should be not missed, come on!

Film 4. Post CMR (R) elbow AP view.

Film 5. Post CMR (R) elbow Lateral view.

CMR was done under sedation. IV Pethidine 50 mg and IV Dormicum 5 mg given. Then back slab was applied, uneventful. Check X-ray was done shows dislocation reduced by me (anaest MO). Patient was given adequate painkiller (T. Voltaren 50 mg tds) and T. Papase II/II tds. TCA also given 2 week to review progress at our OPD. Keep Back slab for 4-6 weeks.

We as a doctor should know how to do reduction of elbow dislocation. And how to do it? i show you in you tube video above...