Clinical Observation of Surgical Treatment of Recurrent Dislocation of the Forearm Bones

Abstract

   AIM OF STUDY. To describe a rare clinical case of surgical treatment of chronic recurrent dislocation of the forearm bones using the method of circular plastic surgery of the elbow joint ligaments.   MATERIAL AND METHODS. In the conditions of the Department of Traumatology and Orthopedics on the basis of the Department of Traumatology and Orthopedics of the Federal State Autonomous Educational Institution of Higher Education “Russian Peoples’ Friendship University” in the V. M. Buyanov City Clinical Hospital of the Moscow Health Department, a comprehensive diagnosis and treatment of a 38-year-old patient with recurrent dislocation of the forearm bones was carried out. Clinical and radiological examinations including computed tomography and magnetic resonance imaging of the elbow joint were performed to verify the diagnosis. After a diagnosis of chronic posterior instability of the elbow joint was established, simultaneous plastic surgery of the medial and lateral ulnar collateral ligaments was performed using a single-loop circular autograft from the peroneus longus tendon.   RESULTS. At a follow-up period of 12 months, a successful clinical result of surgical treatment with restoration of stability and function of the elbow joint was observed. Pain syndrome on the VAS scale decreased to 1 cm (before surgery 0 cm) with physical activity. The amplitude of active movements in the elbow joint after surgery was: flexion 140° (before surgery 135°), extension 5° (before surgery 5°), pronation-supination 150° (before surgery 160°). After surgery: QuickDASH score 26 (before surgery 44 points), OES score 72 (before surgery 45), MEPS score 85 (before surgery 55). MEPS was score 55, OES was score 45, QuickDASH was 44 points, QuickDASH (work section) was score 75.   CONCLUSION. The method of tendon circular plasty of the elbow joint is an effective method of surgical treatment of multidirectional recurrent instability of the elbow joint, helps restore stability and function of the joint and does not lead to limitation of movements.