Purpose
The aim was to show the causes of sideswipe injury and to evaluate functional outcome of these injuries.
Patients and methods
A total of 16 patients presenting with sideswipe injuries around the elbow were managed, and functional results were evaluated between June 2014 and June 2017. Eleven of these patients were males and five were females. The injuries were sustained in the age group between 20 and 50 years. Thirteen patients were affected on the right side and three patients were affected on the left side. Road traffic accident was the cause in all patients. Principles of management followed were first, debridement and stabilization of fractures; second, vascular repair; third, repeated debridement; fourth, nerve repair; and fifth, soft tissue cover. Internal fixation was used as a stabilization modality in all patients ranging from minimal fixation to plating and graft. Primary nerve and tendon repair was carried out in two cases. Skin graft was done in two cases. Mayo elbow performance score was used for evaluation of the results.
Results
The average follow-up period was 23.3 months (12–36 months). A total of 12 cases underwent internal fixation for open injuries of the humerus, radius, and ulna, and four required extraoperative interference, including nerve repair in two cases and skin graft in two cases. The functional outcome according to Mayo elbow performance score was excellent (score >90) in two cases (12.5%), good (score 75–89) in 11 cases (68.75%), fair (score 60–74) in two cases (12.5%), and poor (score <60) in one cases (6.25%).
Conclusion
Sideswipe should be managed timely, aggressively, and an algorithmic procedure should be followed to attain best results. The injury pattern is different for which a multispecialty approach is needed, and an orthopedic, vascular and plastic surgeon must be implicated. Limb salvage is possible in most cases. Educational programs, appropriate legislation, traffic condition improvements, and car design improvements should be encouraged to prevent these complex and devastating injuries.