Fifteen children with an untreated posterior dislocation of the elbow
were seen between 1965 and 1980. Three had a useful range of painless
flexion and were not treated by operation. Twelve had a stiff elbow and had
an open reduction between three weeks and three years after injury. The
triceps was lengthened when it prevented reduction and Kirschner wires were
used when necessary to stabilize the elbow. Complications included a
transient paralysis of the hand in one patient and myositis ossificans with
a rigid elbow in another. The length of follow-up ranged from one to six
years. In eleven patients the average range of flexion was increased
fourfold, and in all children the elbow had a useful range through 90
degrees of flexion. Eleven children said that the function of the arm was
improved. However, four of them had been operated on within six weeks of
the accident and might have regained a functional range of movement with a
short trial of conservative therapy. We now recommend an interval of
conservative treatment for children who are seen three weeks to two months
after injury.