Case history: A 20-year old high-performance taekwondo athlete fell during a competition match and landed on her outstretched and externally rotated right arm. Immediately strong pain in the elbow occured as well as a clearly deformed elbow suspicious of an elbow luxation. The arm was immobilized and the athlete was transported to a maximum-care trauma centre.

Clinical findings/Investigation/Diagnosis: An x-ray proved the elbow luxation. The elbow was repositioned in sedation and the arm was immobilized in a whole-arm splint. Immediate reduction of pain followed without compromise of the neurovascular structures. The follow-up x-ray showed a congruent joint but also "sagging" in the lateral view indicative of instability (Figure 1.). An MRI examination showed the total rupture of the radial and ulnar collateral ligaments and rupture of the extensor muscles.

Therapy and Progression: Because of the extent of the injury operative treatment was recommended: refixation and augmentation of the ligaments and refixation of the extensor muscles. A strict postoperative scheme was provided under continuous physical therapy.

At 6 months post-op the athlete could return to full competitive activity following intensive postoperative rehabilitation. At 9 months postoperative we reported a ROM of 0/10/140 degrees without subjective or clinical signs of joint instability Figure 2.A-B). Muscle power was 5/5 on the Janda scale. The reported extension deficit was not functionally impairing the athlete in any way.

Comments: Elbow luxations are complex injuries that lead to long-term drop outs from competitive sports and require patience as well as a multidisciplinary approach in order to allow athletes to return to their former competitive level.

References:

1. Breulmann FL, Lappen S, Ehmann Y, Bischofreiter M, Lacheta L, Siebenlist S. Treatment strategies for simple elbow dislocation - a systematic review. BMC Musculoskelet Disord. 2024 Feb 16;25(1):148.

No interest to declare