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Endgames Spot Diagnosis

A post-traumatic painful deformity of the elbow

BMJ 2020; 371 doi: (Published 08 October 2020) Cite this as: BMJ 2020;371:m3494
  1. Tun Hing Lui, consultant1,
  2. Xiaohua Pan, professor2 3
  1. 1Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China
  2. 2Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Guangdong Provincial Academician Workstation of Wound repair and Regenerative Medicine, Guangdong, China
  3. 3Department of Trauma and Orthopaedics, Second Affiliated Hospital of Shenzhen University and Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People’s Hospital of Shenzhen, Shenzhen, Guangdong, China
  1. Correspondence to T-H Lui luithderek{at}

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 …

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