Perbandingan Luaran Klinis Neglected Posterior Dislocation pada Sendi Siku yang Ditatalaksana dengan Reduksi Terbuka dengan dan tanpa Fiksasi K-Wire

Abstract

ABSTRACT Background: Neglected posterior dislocation of the elbow is a rare but challenging condition, particularly in developing countries where initial management may be delayed or inadequate. Surgical intervention through open reduction, with or without temporary K-wire fixation, remains a standard approach, but the functional outcome comparison between these two methods is still debated. Objective: To compare the clinical outcomes of neglected posterior elbow dislocation treated with open reduction with and without K-wire fixation. Methods: This analytic observational study with a case-control design included 50 patients treated for neglected posterior elbow dislocation at H. Adam Malik General Hospital, Medan, between January 2020 and December 2024. Subjects were divided into two equal groups (n=25) — those treated with open reduction and K-wire fixation, and those without fixation. Clinical outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score, range of motion (ROM), and joint stability. Statistical analysis employed Chisquare and Fisher’s exact tests, with significance set at p<0.05. Results: The mean age was 33.82±10.73 years, with males comprising 56% of cases. Most injuries were caused by falls (66%), and 76% had dislocation for more than six months before surgery. No significant differences were found between groups regarding qDASH (p=0.551), ROM (p=0.529), or joint stability (p=0.773). Conclusion: There was no statistically significant difference in clinical outcomes between open reduction with and without K-wire fixation in neglected posterior elbow dislocation. Open reduction without K-wire may therefore be considered a viable alternative, particularly in resource-limited settings. Keywords: neglected elbow dislocation, open reduction, K-wire fixation, qDASH, range of motion, joint stability.