Posterolateral dislocation of the elbow is an injury commonly treated in the emergency department by closed reduction. Very rarely it can be irreducible and require open reduction. Only four cases of irreducible posterolateral elbow dislocation have been described in the literature over the past 50 years. We report the case of a 20-year-old man who sustained such an injury. Open reduction was performed and revealed the radial head protruding or ‘buttonholing’ through the lateral collateral ligament complex. This case highlights that continued closed reduction of the elbow should not be attempted, as a mechanical block to reduction can occur making reduction impossible.
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Contributors CF, MMZ, GS and SK were involved in the patient's initial assessment, management and treatment. All authors were involved in the surgical management. CF was responsible for the images taken. All authors were involved in the writing and editing of the case.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.