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Neglected Convergent Elbow Dislocation in a Paediatric Patient: A Case Report

Case Report | Volume 11 | Issue 3 | September-December 2025 | Page: 20-23 | Vivek Singh, Rahul Baishya, Rahul Mishra, Manish Kumar Shah, Dhaval Patel, Aditya K.S. Gowda DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.248 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2025; The Author(s). Submitted: 21/09/2025; Reviewed: 14/10/2025; Accepted: 10/11/2025; Published: 10/12/2025 Authors: Vivek Singh […]

Unilateral Perthes Disease Followed by Contralateral Pre-slip SCFE: A Case with Sequential Hip Disorders

Case Report | Volume 11 | Issue 3 | September-December 2025 | Page: 16-19 | Tariq Altaf Mir, Muhammad Haseeb Gani DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.246 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2025; The Author(s). Submitted: 19/09/2025; Reviewed: 30/09/2025; Accepted: 24/11/2025; Published: 10/12/2025 Authors: Tariq Altaf Mir MS Ortho [1], Muhammad Haseeb Gani MS […]

Neglected Convergent Elbow Dislocation in a Paediatric Patient: A Case Report

Unilateral Perthes Disease Followed by Contralateral Pre-slip SCFE: A Case with Sequential Hip Disorders

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Neglected Convergent Elbow Dislocation in a Paediatric Patient: A Case Report

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.248

Open Access License: CC BY-NC 4.0

Submitted: 21/09/2025; Reviewed: 14/10/2025; Accepted: 10/11/2025; Published: 10/12/2025

Authors: Vivek Singh MS Ortho [1], Rahul Baishya MS Ortho [1], Rahul Mishra MS Ortho [1], Manish Kumar Shah MBBS [1], Dhaval Patel MBBS [1], Aditya K.S. Gowda MS Ortho [1]

[1] Department of Orthopedics, Paediatric Orthopaedics Unit, AIIMS, Rishikesh, Uttarakhand, India.

Address of Correspondence
Dr. Aditya K.S. Gowda,
Department of Orthopaedics, AIIMS, Rishikesh, Uttarakhand, India, 249203
E-mail: adityajr.orth@aiimsrishikesh.edu.in

Abstract

Background: Convergent elbow dislocation is a rare paediatric injury with medial translocation of both radius and ulna. Subtle radiographic signs lead to missed diagnoses and delayed treatment.
Case presentation: We evaluated an 11-year-old girl with persistent restriction of forearm rotation and ulnar-nerve symptoms two months after a “simple” elbow dislocation that underwent a closed reduction. The diagnostic work-up included targeted review of the radiographs and non-contrast computerized tomography (CT). Operative management was performed through a posterior approach to the elbow with release of the scar tissue, ulnar-nerve decompression, open reduction, and Kirschner wire (K-wire) stabilization of the radiocapitellar joint.
Results: Pre-operative imaging confirmed convergent radioulnar translocation and anterior calcification (“radial horn”). After K-wire removal and rehabilitation, the patient achieved functional pronation–supination and resolution of ulnar neuropathy. At 24 months follow-up, radiographs showed maintained reduction and a stable, painless elbow with symmetric range of motion.
Conclusions: In the management of trauma to the elbow in children, post-reduction restriction of forearm rotation should raise the suspicion of rare injury patterns such as convergent radioulnar dislocation. In case of delayed presentation, prompt recognition and comprehensive soft-tissue release with nerve decompression can yield excellent function.
Keywords: Elbow dislocation, Convergent dislocation, Child, Ulnar neuropathy, Open reduction.

References

1. Speed JS. Dislocation of the elbow in children. J Bone Joint Surg. 1925;7(2):255-259.
2. Borris LC, Lassen MR. Convergent dislocation of the elbow. Injury. 1982;14(2):166-169.
3. Gupta P, et al. Convergent dislocation of the elbow: A rare injury. J Orthop Case Rep. 2016;6(3):48-50.
4. Keny S, Modi N, et al. PRUT – A cadaveric study to understand the mechanism of this rare paediatric elbow injury. Trauma Case Rep. 2024;52:101067.
5. Bhaskaranand K, Bhat AK. Missed Monteggia fracture in children. Indian J Orthop. 2000;34(2):110-114.
6. D’Ambrosia R, et al. Ulnar nerve palsy in elbow dislocations. Clin Orthop Relat Res. 1981;(161):170-174.
7. Rehima S, et al. Convergent dislocation in children – case report and review. Eur J Orthop Surg Traumatol. 2012;22(3):221-224.
8. Smith FM. Unusual dislocations at the elbow. Am J Surg. 1956;91(4):560-568.
9. Weseley MS, Barenfeld PA. Ulnar nerve injury after elbow trauma. Orthop Clin North Am. 1976;7(2):403-413.
10. Singh D, et al. Late presentation of Paediatric elbow dislocation. J Clin Orthop Trauma. 2018;9(1):63-67.
11. Modabber MR, Jupiter JB. Reconstruction for neglected elbow fracture-dislocations. Hand Clin. 2002;18(1):91-102.

How to Cite this Article: Singh V, Baishya R, Mishra R, Shah MK, Patel D, Gowda AKS. Neglected Convergent Elbow Dislocation in a Paediatric Patient: A Case Report. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3): 20-23.

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Unilateral Perthes Disease Followed by Contralateral Pre-slip SCFE: A Case with Sequential Hip Disorders

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.246

Open Access License: CC BY-NC 4.0

Submitted: 19/09/2025; Reviewed: 30/09/2025; Accepted: 24/11/2025; Published: 10/12/2025

Authors: Tariq Altaf Mir MS Ortho [1], Muhammad Haseeb Gani MS Ortho [1]

[1] Paediatric Orthopaedics Department, Paras Health, Srinagar, India.

Address of Correspondence
Dr. Tariq Altaf Mir,
Consultant, Paediatric Orthopaedics Department, Paras Health, Srinagar, India.
E-mail: mirdadtariq@protonmail.com

Abstract

Background: Perthes disease and Slipped Capital Femoral Epiphysis (SCFE) are distinct paediatric hip disorders, rarely reported to occur sequentially in the same patient.
Case report: We report a case of a 7-year-old boy with Perthes disease of the Right hip treated by proximal femoral osteotomy. At the age of 9 years, he complained of Left hip pain, which on evaluation was found to be a pre-slip SCFE. He underwent in-situ pinning on the Left side and was asymptomatic at the last follow-up.
Conclusion: Recognition of this sequential presentation is important for surveillance and timely management.
Keywords: SCFE, Perthes disease, Vitamin D deficiency

References

1. Karkenny AJ, Tauberg BM, Otsuka NY. Pediatric hip disorders: Slipped capital femoral epiphysis and Legg-Calvé-Perthes disease. Pediatr Rev. 2018 Sep;39(9):454–63. doi:10.1542/pir.2017-0197. PMID: 30171056.
2. Markheim HR. Legg-Perthes disease and slipped epiphysis in the same patient: a case report. J Bone Joint Surg Am. 1949;31A:666–8.
3. Graziano GP, Kernek CB, DeRosa GP. Coexistent Legg-Calvé-Perthes disease and slipped capital femoral epiphysis in the same child. J Pediatr Orthop. 1987;7:61–2. doi:10.1097/01241398-198701000-00012.
4. Singh KA, Madegowda A, Shah H. Slipped capital femoral epiphysis in a healed Perthes hip. BMJ Case Rep CP. 2021;14:e243977.
5. Madhuri V, Arora SK, Dutt V. Slipped capital femoral epiphysis associated with vitamin D deficiency: a series of 15 cases. Bone Joint J. 2013 Jun;95-B(6):851–4. doi:10.1302/0301-620X.95B6.30806. PMID: 23723284.

How to Cite this Article: Mir TA, Gani MH. Unilateral Perthes Disease Followed by Contralateral Pre-slip SCFE: A Case with Sequential Hip Disorders. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3): 16-19.

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