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Traumatic Divergent Elbow Dislocation in an Adult with an Associated Fracture of the Distal Part of the Humeral Shaft and an Open Perilunate DislocationA Case Report
E. Christopher Casstevens, MD1; Ryan P. Calfee, MD2; Peter J. Stern, MD1
1 Department of Orthopaedic Surgery, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, P.O. Box 670212, Cincinnati, OH 45267-0212. E-mail address for E.C. Casstevens: chris.casstevens@uc.edu
2 Department of Orthopaedic Surgery, School of Medicine, Washington University, 660 Euclid Avenue, St. Louis, Missouri 63110
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Investigation performed at University of Cincinnati, College of Medicine, Cincinnati, Ohio



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Oct 24;2(4):e61 1-6. doi: 10.2106/JBJS.CC.K.00181
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Extract

Divergent dislocation of the elbow represents an extremely rare injury. The proximal radioulnar joint is disrupted as the distal part of the humerus is driven between the radius and ulna, and the forearm dislocates posteriorly. We believe that DeLee, in 1981, reported the first modern case of divergent elbow dislocation that was confirmed by radiographs in a child1. Subsequently, to the best of our knowledge, there have been twenty-one additional reported cases of divergent elbow dislocation in children2-19. We identified only one previously published case report of traumatic divergent elbow dislocation in an adult20. We present an adult patient with a traumatic divergent dislocation of the elbow with an associated humeral fracture and an open perilunate dislocation. The patient was informed that data concerning the case would be submitted for publication, and he provided consent; the institutional review board approved the submission.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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