Divergent elbow dislocation and risk of compartment syndrome.

BACKGROUND Divergent pediatric elbow dislocations are very rare injuries. CASE An eight-year-old boy presented to the emergency department with elbow pain after a fall. On examination his elbow was swollen; skin and neurovascular function were intact. Radiographs demonstrated a divergent elbow dislocation. After successful closed reduction under sedation, the arm was casted; gentle motion was initiated at three weeks. At four months, the patient had full strength, no symptoms, and nearly full range of motion. INTERPRETATION The literature on the treatment of this injury is limited because of its rarity. We present a case of successful nonoperative management. The return of this patient for compressive symptoms should serve as a reminder that these injuries may be at high risk for compartment syndrome, possibly due to the high level of soft tissue disruption.