Interventions for treating acute elbow dislocations in adults

Taylor, Frances; Sims, Martyn; Theis, Jean‐Claude; Herbison, G Peter

doi:10.1002/14651858.cd007908.pub2

Cited by 19 publications

(17 citation statements)

References 13 publications

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“…Taylor et al [4] reported that more than 90% of simple elbow dislocations occur in a posterior or posterior lateral direction, compared to 87.5% in the herein study. Anakwe et al [24] suggested that the epidemiology of simple elbow dislocation is different between men and women, particularly with respect to the mechanism of injury, and that it correlated with patient's age.…”

Section: Discussioncontrasting

confidence: 52%

“…None of our patients with a simple elbow dislocation was treated with an early surgical reconstruction. Noteworthy, the existing evidence does not suggest that surgical repair of elbow ligaments for simple elbow dislocation improves long-term function [4,20] . The current literature is limited in terms of the health economics of treating simple elbow dislocations.…”

Section: Discussionmentioning

confidence: 99%

“…Inclusion criteria comprised of skeletally mature patients with clinically and/or radiologically confirmed acute "simple" elbow dislocations, having at least one year of follow-up. "Simple" dislocation were defined as dislocations that involved soft tissue disruption ( Figure 1) [4] . Exclusion criteria included: associated fractures, with the exception of avulsion fractures ("complex" elbow dislocations; Figure 2); open wounds requiring debridement in the operating room; and patients with inadequate followup, defined as patients not attending three consecutive appointments at the outpatients clinic, or being followed up by another institution.…”

Section: Methodsmentioning

confidence: 99%

“…The most commonly used classification system of elbow dislocation is based on the presence of concomitant fractures in the region. Simple dislocations are characterised by the absence of fractures (except from avulsion fractures) [4] , whereas complex dislocations are those accompanied by fractures [5,6] . The terrible triad describes a complex posterior dislocation with an intraarticular fracture of the radial head and of the coronoid process [6] .…”

Section: Introductionmentioning

confidence: 99%

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Cost analysis and outcomes of simple elbow dislocations

Panteli

Pountos

Kanakaris

et al. 2015

WJO

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AIM:To evaluate the management, clinical outcome and cost implications of three different treatment regimes for simple elbow dislocations. METHODS:Following institutional board approval, we performed a retrospective review of all consecutive patients treated for simple elbow dislocations in a Level Ⅰ trauma centre between January 2008 and December 2010. Based on the length of elbow immobilisation (LOI), patients were divided in three groups (Group I, < 2 wk; Group Ⅱ, 2-3 wk; and Group Ⅲ, > 3 wk). Outcome was considered satisfactory when a patient could achieve a pain-free range of motion ≥ 100° (from 30° to 130°). The associated direct medical costs for the treatment of each patient were then calculated and analysed. RESULTS:We identified 80 patients who met the inclusion criteria. Due to loss to follow up, 13 patients were excluded from further analysis, leaving 67 patients for the final analysis. The mean LOI was 14 d (median 15 d; range 3-43 d) with a mean duration of hospital engagement of 67 d (median 57 d; range 10-351 d). Group Ⅲ (prolonged immobilisation) had a statistically significant worse outcome in comparison to Group Ⅰ and Ⅱ (P = 0.04 and P = 0.01 respectively); however, there was no significant difference in the outcome between groups Ⅰ and Ⅱ (P = 0.30 Core tip: Our study demonstrates that prolonged immobilisation following simple elbow dislocations may lead to detrimental effects. We therefore stress the need for increased vigilance to the duration of immobilisation and that every effort should be taken to ensure that without associated fractures, the elbow should not be immobilised for more than three weeks. In addition, our study supports that the direct medical cost from treating these injuries may be substantial regardless of the type of treatment, and this should be known both by commissioners and providers of health care.Panteli M, Pountos I, Kanakaris NK, Tosounidis TH, Giannoudis PV. Cost analysis and outcomes of simple elbow dislocations. World J Orthop 2015; 6(7): 513-520 Available from: URL:

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cost analysis and outcomes of simple elbow dislocations

Panteli

Pountos

Kanakaris

et al. 2015

WJO

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“…Review articles already published on simple elbow dislocation (19,20) found no difference between surgery and conservative therapy but included in their analysis only one randomized controlled trial comparing the two-dating from 1987 (21). Regarding conservative therapy, they also leave unclear whether early functional therapy is superior to plaster cast immobilization.…”

mentioning

confidence: 99%