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Elbow: traumatic luxation
Introduction
- Uncommon. Usually in dogs over 1 year of age.
- Usually lateral luxation of the antebrachium.
- Signs: carriage of limb in semi-flexion, distal limb abducted and supinated.
- Treatment: relocation by closed reduction, or open reduction +/- reconstruction of damaged collateral ligament.
- Prognosis: good, secondary osteoarthritis common sequela.
Cost considerations
- Simple cases with no collateral ligament compromise can often be dealt by coaptation alone following reduction under general anesthetic.
- Surgical reduction and/or stabilization may be required in chronically luxated cases or cases with collateral ligament insufficiency.
Pathogenesis
Etiology
- Trauma - lateral twisting of the antebrachium with the elbow flexed more than 45° (in extension luxation is prevented by the anconeal process engaging in the supratrochlear foramen).
Pathophysiology
- Usually lateral antebrachial displacement because larger medial epicondyle of humerus prevents medial displacement.
- Organization of the intra-articular hematoma that forms following luxation often occurs quickly. This may make delayed closed reduction difficult/impossible.
- Collateral ligament damage may result in permanent elbow instability - requires reconstruction.
- Osteoarthritic change Arthritis: osteoarthritis may occur as a long-term sequela.
Diagnosis
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Treatment
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Prevention
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Outcomes
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