Stiffness after neglected elbow trauma in children: a report of 57 cases

Neglected trauma of the elbow in the child is not rare, especially in countries where traditional treatment is still practiced. The authors report a study of 57 neglected elbow trauma in children and the complication of stiffness managed in the pediatric orthopedics department in Rabat, Morocco, between 1996 and 2002. Average patient age was 11 years, location predominated at the right elbow, and the average delay of consultation was 7 months after the trauma. Clinical examination found 36% of stiffness in bending, 29% in extension, and 35% mixed. Of these, 43% were judged very serious, 20% serious, and 37% moderate. Radiological finding showed 35 neglected elbow dislocations (61%), ten supracondylar humeral fractures (17%), and 12 posterior lesions difficult to determine. Abstention from surgery was recommended for 12 patients; 45 were operated on. The end result was 53% with minimal and moderate stiffness. The authors analyzed clinical and therapeutic aspects of all lesions, insisting on abstention from surgery according to the variable and unforeseen character of surgery results.