Management Of Recent Elbow Dislocations: Functional Treatment Versus Immobilization; A Prospective Study About 60 Cases

Abstract

Objective:To determine our therapeutic posture trough a comparison of functional treatment results versus immobilization in two different periods.Introduction:For years, the treatment of recent elbow dislocations consisted of reduction and immobilization during 21 days. Given the frequency of stiffness other methods have been tried out.Method:A prospective study was carried out from January 2010 to December 2014. Sixty patients averaging 28.3 years of age underwent elbow dislocation reduction. They were categorized into three separate groups. Patients in the first group had their elbow immobilized for 21 days whereas Group 2 patients were immobilized for 10 days. Group 3 patients were applied a functional treatment followed by a functional rehabilitation. Patients were evaluated according to the Mayo Clinic Elbow Performance Index and the results analyzed with statistical software (SPSS, version 18).Results:During the first month, the functional results of the patients were excellent and good in 19%, 94.7% and 90% respectively for Groups 1, 2 and 3. The pain was intense (10 on the visual analogue scale) in group 3 associated with swelling. At day 90, the results of the patients in Groups 2 and 3 were excellent in 100% of the cases versus 90% for Group 1. At 6 months, all the results were the same. We have not noted any instability, or recurrence or periarticular ossification in our patients.Conclusion:The treatment of stable elbow dislocations remains orthopedic. The risk of instability and pain motivates a short 10-day immobilization period followed by early mobilization.

Reasons for surgical revision after conservatively treated radial head fractures—retrospective study of 70 patients

“…Our study involved only patients undergoing surgery for fracture sequelae such as instability, restricted range of motion (stiffness), or painful weight-bearing. Elbow stiffness described in the literature, which is significantly correlated with the duration of immobilization, is a serious complication after radial head fractures [ 8 , 29 , 30 , 33 – 35 , 41 , 42 ]. This was also found in the present study.…”

“…1 and 2 ). Conservative therapy includes immobilization for 5–7 days followed by early functional treatment [ 8 , 29 , 30 , 33 , 41 , 42 ]. The outcomes after conservative treatment are good to very good in about 90% of cases [ 17 , 43 , 45 ].…”

Early functional mobilization for non-operative treatment of simple elbow dislocations: a systematic review

“…Three randomized control studies compared early mobilization versus PoP immobilization for 21 days. 22,23,25 Although studies demonstrated expeditated return of ROM, the two studies analyzing pain scores demonstrated significantly higher pain during the rehabilitation period compared to PoP casting for 21 days. Despite increase pain, there was no difference in adverse effects in any study between early mobilization and PoP casting for 21 days.…”

“…A total of 15 papers were included for analysis after title, abstract, and full-text screen (Figure 1). [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Of the 15 included studies, 3 studies were level II 22,23,25 or higher while 12 studies were level II or lower [16][17][18][19][20][21]24,[26][27][28][29][30] (Table 1). Of the studies level II or greater, the mean sample size was 60 patients (range 50-100), with a pooled total of 210 cases of simple elbow dislocations.…”