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A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management

INTRODUCTION: Elbow dislocation usually presents with a deformity and swelling, yet it can also present with neurological complication. Nerve injury with dislocation is common in the pediatric age group and is reported infrequently among adults. The most common nerve involved with dislocation is the...

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Autores principales: Kamble, Prashant, Prabhakar, Akil, Wankhade, Ajay M, Mohanty, S S, Rathod, Tushar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8930389/
https://www.ncbi.nlm.nih.gov/pubmed/35415152
http://dx.doi.org/10.13107/jocr.2021.v11.i12.2578
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author Kamble, Prashant
Prabhakar, Akil
Wankhade, Ajay M
Mohanty, S S
Rathod, Tushar
author_facet Kamble, Prashant
Prabhakar, Akil
Wankhade, Ajay M
Mohanty, S S
Rathod, Tushar
author_sort Kamble, Prashant
collection PubMed
description INTRODUCTION: Elbow dislocation usually presents with a deformity and swelling, yet it can also present with neurological complication. Nerve injury with dislocation is common in the pediatric age group and is reported infrequently among adults. The most common nerve involved with dislocation is the ulnar nerve followed by the median nerve. The median nerve usually slips medially during dislocation and gets entrapped posterior to the medial epicondyle or it can get entrapped between the fractured medial epicondyle. Here, we describe a unique case of posterolateral elbow dislocation in a 30-year-old female patient with having lateral displacement of the median nerve and the mechanism probably by which the nerve got displaced laterally. CASE PRESENTATION: A 30-years-old female patient of right hand dominant came to us with a left elbow injury after a road traffic accident. Clinical and Radiological examination revealed a posterior-lateral dislocated elbow with a fracture of the radial head and lateral condyle avulsion. Clinically, there was a weakness and sensory hypoesthesia along the median nerve distribution over the left hand and forearm. Initially, closed reduction and splinting done. Later, a planned surgery with a lateral approach avulsed lateral condyle and radial head fixation done with relocation of the median nerve, which was displaced laterally. CONCLUSION: There are numerous cases of elbow dislocation with nerve involvement and their complications have been previously described throughout literature. Here, we present a rare case of lateral displacement of the median nerve in a dislocated elbow and the possible mechanism with its management.
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spelling pubmed-89303892022-04-11 A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management Kamble, Prashant Prabhakar, Akil Wankhade, Ajay M Mohanty, S S Rathod, Tushar J Orthop Case Rep Case Report INTRODUCTION: Elbow dislocation usually presents with a deformity and swelling, yet it can also present with neurological complication. Nerve injury with dislocation is common in the pediatric age group and is reported infrequently among adults. The most common nerve involved with dislocation is the ulnar nerve followed by the median nerve. The median nerve usually slips medially during dislocation and gets entrapped posterior to the medial epicondyle or it can get entrapped between the fractured medial epicondyle. Here, we describe a unique case of posterolateral elbow dislocation in a 30-year-old female patient with having lateral displacement of the median nerve and the mechanism probably by which the nerve got displaced laterally. CASE PRESENTATION: A 30-years-old female patient of right hand dominant came to us with a left elbow injury after a road traffic accident. Clinical and Radiological examination revealed a posterior-lateral dislocated elbow with a fracture of the radial head and lateral condyle avulsion. Clinically, there was a weakness and sensory hypoesthesia along the median nerve distribution over the left hand and forearm. Initially, closed reduction and splinting done. Later, a planned surgery with a lateral approach avulsed lateral condyle and radial head fixation done with relocation of the median nerve, which was displaced laterally. CONCLUSION: There are numerous cases of elbow dislocation with nerve involvement and their complications have been previously described throughout literature. Here, we present a rare case of lateral displacement of the median nerve in a dislocated elbow and the possible mechanism with its management. Indian Orthopaedic Research Group 2021-12 /pmc/articles/PMC8930389/ /pubmed/35415152 http://dx.doi.org/10.13107/jocr.2021.v11.i12.2578 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kamble, Prashant
Prabhakar, Akil
Wankhade, Ajay M
Mohanty, S S
Rathod, Tushar
A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management
title A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management
title_full A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management
title_fullStr A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management
title_full_unstemmed A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management
title_short A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management
title_sort rare case of lateral displacement of median nerve in a dislocated elbow and its management
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8930389/
https://www.ncbi.nlm.nih.gov/pubmed/35415152
http://dx.doi.org/10.13107/jocr.2021.v11.i12.2578
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