Treatment should go under the Discussion heading.

Here's the reasoning for your poster structure:

The Case Report section can briefly mention what treatment was performed (e.g., "the patient underwent open reduction"), but the rationale, technique details, alternatives, and literature comparison all belong in the Discussion.

This is standard for case report posters - the discussion is where you interpret and contextualize your findings, and treatment decisions are part of that interpretation.

The Discussion section should cover these points for your case:

Key message for your discussion: Neglected elbow dislocation requires a staged soft tissue strategy - the Bell-Tawse procedure removes the mechanical block to reduction, and the Tommy John reconstruction restores the ligamentous stability that has been lost over the neglect period. Together they address both the reduction and the post-reduction stability, which is the unique aspect of your case.

Here is a short discussion suitable for a poster:

Neglected elbow dislocation, defined as a dislocation presenting more than three weeks after injury, poses a significant surgical challenge due to progressive fibrosis, capsular contracture, and ligamentous insufficiency. Simple closed reduction is invariably unsuccessful in these cases, necessitating open surgical intervention.

In our case, open reduction was performed following soft tissue release using the Bell-Tawse procedure, which involves lengthening of the triceps and release of the posterior capsular contracture. This step is critical to eliminate the mechanical block caused by organized fibrous tissue and contracted posterior structures, allowing safe joint reduction without undue force.

Following reduction, medial instability was addressed using the Tommy John procedure - ulnar collateral ligament (UCL) reconstruction with a tendon graft. In neglected dislocations, the UCL is chronically disrupted and incapable of providing valgus stability. Reconstruction restores medial-sided stability and significantly reduces the risk of re-dislocation.

The combination of Bell-Tawse release, open reduction, and UCL reconstruction provided a systematic approach to the two main problems in neglected dislocation - the block to reduction and the instability after reduction. Post-operatively, the patient was immobilized briefly followed by supervised physiotherapy to restore range of motion.

This case highlights that neglected elbow dislocations require more than simple open reduction. Addressing soft tissue contracture and ligamentous instability in the same surgical setting leads to a stable, functional elbow and a satisfactory outcome.

This is approximately 230 words, appropriate for a poster format. You can shorten further if needed.

Neglected elbow dislocation (>3 weeks) cannot be reduced by closed means due to capsular fibrosis and soft tissue contracture. Open reduction is mandatory. The Bell-Tawse procedure releases the contracted posterior structures, eliminating the mechanical block to reduction. Following reduction, the chronically disrupted ulnar collateral ligament was reconstructed using the Tommy John procedure to restore medial stability and prevent re-dislocation. This combined approach effectively addresses both the block to reduction and post-reduction instability, resulting in a stable, functional elbow.

~80 words. Ideal for a poster.

When someone asks why your case is special, say:

1. Rare presentation - Neglected elbow dislocations are uncommon because most patients seek treatment early. A dislocation left unreduced for more than three weeks with significant soft tissue changes is not commonly reported.

2. Unique surgical combination - Most published cases of neglected elbow dislocation are managed with open reduction alone or with simple capsular release. In our case, we combined the Bell-Tawse procedure with the Tommy John (UCL reconstruction) in the same sitting - this combination is rarely described in literature for neglected dislocations.

3. Tommy John in a non-athlete - The Tommy John procedure is classically described for overhead throwing athletes with UCL tears. Using it in the context of a neglected dislocation to restore chronic ligamentous instability is a novel application, making this case educationally significant."

Here are a few versions - pick the one that suits your style:

Option 1 (confident): "Most published cases of neglected elbow dislocation are managed with open reduction alone or basic soft tissue release. We went a step further - combining the Bell-Tawse procedure for contracture release with Tommy John UCL reconstruction in a single surgical sitting, a combination that has rarely been reported in the context of neglected dislocations."

Option 2 (simple and clear): "While open reduction with capsular release is the standard reported approach for neglected elbow dislocation, our case uniquely combined the Bell-Tawse procedure with UCL reconstruction (Tommy John) in the same surgery - simultaneously tackling both the mechanical block to reduction and the resulting ligamentous instability."

Option 3 (for verbal presentation): "What sets this case apart surgically is that we did not stop at just reducing the joint. We combined Bell-Tawse release with Tommy John UCL reconstruction in one sitting - something not commonly described together in neglected dislocation cases in literature."

Option 2 is best for a poster. Option 3 is best for speaking to an examiner or audience.

Yes, absolutely. You can add it as the last line of your discussion to emphasize the novelty of your case.

Your updated discussion would look like this:

Neglected elbow dislocation (>3 weeks) cannot be reduced by closed means due to capsular fibrosis and soft tissue contracture. Open reduction is mandatory. The Bell-Tawse procedure releases the contracted posterior structures, eliminating the mechanical block to reduction. Following reduction, the chronically disrupted ulnar collateral ligament was reconstructed using the Tommy John procedure to restore medial stability and prevent re-dislocation. While open reduction with capsular release is the standard reported approach for neglected elbow dislocation, our case uniquely combined the Bell-Tawse procedure with UCL reconstruction (Tommy John) in the same surgery - simultaneously tackling both the mechanical block to reduction and the resulting ligamentous instability.

This flows naturally and ends on a strong note highlighting what makes your case unique. Works well for a poster.