A post-traumatic painful deformity of the elbow

A woman in her 60s fell on her partially extended right elbow, resulting in painful deformity of the elbow with a posterolateral dimple (fig 1). She was otherwise healthy. Fig 1 Deformity of the patient’s right elbow: dislocated radial head (a), olecranon (b), and tensed triceps tendon (c) resulting in a skin depression (d) just proximal to the radial head On examination, she had no neurovascular deficit. She could not move her elbow because of severe pain in the joint and surrounding muscle guarding. The deformity was fixed (the elbow could not be flexed or extended). No bruising was visible around the elbow joint, which suggested that no substantial muscle tearing had occurred, and anteroposterior and lateral radiography (fig 2) showed no fractures. The …