The anatomical basis of Z‐musculoplasty of the triceps brachii for longstanding dislocated elbows treated by open reduction

Patients presenting late with an unreduced posterior dislocation of the elbow are still a problem in developing countries and a challenge for surgeons. In developing countries, socio‐economical and cultural factors may affect the medical care of traumatic injuries. Due to misconception, ignorance and poverty, patients go to local bonesetters to tradition treatment such as massage and manipulation which only aggravate the situation. Unreduced is defined as those posterior dislocated elbow not treated within 3 weeks after injury. These elbows are often fixed in extension and have no sufficient ranges of movements which allow activities of daily living. Between January 2008 and June 2008, 15 cases of late‐presenting unreduced posterior dislocation of elbow were treated in the department of Surgery at Butare Teaching Hospital. They were 7 males and 8 were female, the age from 12 years to 72 years (mean, 31), the dislocated elbows were right for 7 patients and left for 8 patients. The time since the injury range 4 to 8 (mean, 5) months. All patients had no‐functional movements for the daily activities as the elbows were fixed in 10° to 50° (mean, 25°) of flexion. All patients were operated and open reduction were performed using the posterior approach of the elbow. The triceps was lengthened using a Z musculoplasty technique which, for our best of knowledge, is not yet described. In our previous cases we find difficulty to repair the triceps muscle when applying the common V‐Y musculoplasty technique. In this poster we present the anatomical basis of the Z musculoplasty of the triceps<