Der Unfallchirurg
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Dislocation of the elbow joint is the second most common dislocation, the shoulder being the most common. Non-surgical therapy is done by repositioning and early active motion after a short period of immobilization. There are, however, certain principles which must be followed in order to obtain a favorable result with functional therapy. ⋯ Knowing the mechanism or kinematics of an elbow dislocation, it is possible to determine a staging of the injury. Using detailed x-rays and an exact stability test, the degree of instability must be checked after repositioning. It is important to determine the grade of instability and to operatively correct a major instability.
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Fractures in children require special knowledge and skills due to the differences in biological and biomechanical properties of growing skeletons. Children suffer from fractures of the upper extremities much more than fractures of the lower extremities. ⋯ In order to correctly decide about treatment regimes (conservative versus operative treatment) the limitations and limits of the ability of bone to correct misalignment must be anticipated. Clinical examination following fracture healing is mandatory to recognize differences in length, misalignment and deficits in function, which should receive further treatment.