Posterior dislocation of the elbow as an unusual presentation after a total hip replacement: a case report

We report a case of posterior dislocation of the elbow occurring in a patient while using her arm to lift herself using a monkey pole on the second day following a total hip replacement. The dislocation was reduced under sedation in the ward. There were no signs or symptoms suggesting any joint hypermobility syndrome in the patient. Follow up 4 months following the injury revealed a complete recovery in the range of motion and a pain free elbow. There were no signs and symptoms of any instability.This is the first time such a case is reported in the literature. It certainly demonstrates that even in the absence of instability a patient can be predisposed to low energy dislocation of the elbow.Posterior dislocation of elbow is infrequent but not uncommon [1]. Elbow dislocation is the second most common type of dislocation encountered in the adult population. The majority of these can be treated by closed manipulation and relocation [2]. It is well recognized that simple dislocations are commonly associated with good outcomes after a closed reduction and institution of early motion [3].We report an unusual case of posterior dislocation of an elbow in an adult while trying to get out of bed using a monkey pole on the second post operative day after a hip replacement.This is the first case to be reported in the literature with such an unusual mechanismA 27 year woman, previously fit and healthy, who has congenital arteriovenous malformations localised to the right lower limb was seen in the orthopaedic clinic with a painful right hip. Assement of her hip confirmed a severely arthritic hip with radiological features of secondary arthritis associated with developmental dysplasia of the hip joint. She underwent an elective total hip replacement (Figure 1 and 2).Surgery was performed routinely. While undertaking standard mobilisation, the patient was trying to get out of her bed on the second day post operation, heared a pop and presented with a painful deformed elbow on th