Simple elbow dislocation among adults: A comparative study of two different methods of treatment

Maripuri, Subramanyam Naidu; Debnath, Ujjwal K.; Rao, Pallavi; Mohanty, Khitish

doi:10.1016/j.injury.2007.02.040

Cited by 111 publications

(94 citation statements)

References 14 publications

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“…After early mobilization and fixation with a cast after reduction, the time taken for returning to the job was 10 and 18 days, respectively, in the study by Iordens et al (14), but 3.2 and 6.6 days, respectively, in the study by Maripuri et al (9) In our study, patients returned to their jobs after 12 days (range, 10-16 days) on average. In the literature, the rate of repeating dislocation after simple elbow dislocations is 0.6%.…”

Section: Discussioncontrasting

confidence: 41%

“…In a randomized controlled study, no difference was found between the group undergoing early mobilization and the group undergoing immobilization in terms of flexion and extension at the end of 1 year, but restricted extension was detected in the early mobilization group in the 3-month controls (8,12). There are some retrospective studies stating that early mobilization was better at 6-month follow-ups for pain and restricted movement (8,9). Fourteen patients included in the study started immobilization for 1 week and then early mobilization after closed reduction.…”

Section: Discussionmentioning

confidence: 99%

“…However, long-term immobilization can lead to stiffness and contractures in the elbow (7). In the literature, there are retrospective studies reporting that early mobilization is better at 6-month follow-ups in terms of pain and movement restriction (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Results of Closed Reduction and Early Rehabilitation in Simple Elbow Dislocations

Ataoğlu¹,

Ayanoğlu²,

Elshan³

et al. 2017

JAREM

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Objective: To share the outcomes of closed reduction and early mobilization in patients with simple elbow dislocation.Methods: From 2008 to 2015, 18 adult patients with simple elbow dislocations were enrolled in the Emergency Department of our hospital. All the patients received closed reduction under sedation. After reduction, a long arm cast was applied to all patients for one week. Early active movement was begun at the end of this week. Patients were not allowed to do passive stretching exercises for three weeks. All patients were followed up at the first week, sixth week and first year. Patients were evaluated both radiographically and functionally with Quick-DASH and Oxford Elbow Score. The results were evaluated by comparison with patients' contralateral elbow.Results: Quick-DASH scores at 1 year were 5.0 in the dislocation group versus 4.0 in the contralateral elbow. Oxford Elbow Scores at 1 year were 91 in the dislocation group versus 95 in the contralateral elbow. There was no significant relationship between the two groups at the first year controls (p>0.05). There was no significant difference in terms of range of motion (p>0.05). Patients returned to work sooner after early mobilization (average of 12 days). No recurrent dislocations occurred. After one year, there was no significant deterioration with radiographic joint integrity in any patient. Conclusion:Early active mobilization is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier compared to plaster immobilization.

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Section: Discussioncontrasting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

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Results of Closed Reduction and Early Rehabilitation in Simple Elbow Dislocations

Ataoğlu¹,

Ayanoğlu²,

Elshan³

et al. 2017

JAREM

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“…Moreover, ligamentous repair may not be sufficient to stabilize the elbow in such a way that immediate active movement is tolerated [5,28]. Plaster immobilization is unattractive, because earlier studies found that mobilization is essential during healing of injured ligaments because the functional load on the collagen fibers prevents contracture and the risk of stiffness [1,11,17,20,27,29,37]. Another alternative is the hinged external fixator, which stabilizes the elbow and protects the elbow against valgus and varus stress and allows flexion and extension.…”

Section: Introductionmentioning

confidence: 99%

Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

Iordens

Hartog

Lieshout

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background After a complex dislocation, some elbows remain unstable after closed reduction or fracture treatment. Function after treatment with a hinged external fixator theoretically allows collateral ligaments to heal without surgical reconstruction. However, there is a lack of prospective studies that assess functional outcome, pain, and ROM. Questions/purposes We asked: (1) In complex elbow fracture-dislocations, does treatment with a hinged external fixator result in reduction of disability and pain, and in improvement in ROM, function, and quality of life? (2) Does delayed treatment (7 days or later) have a negative effect on ROM after 1 year? (3) What are the complications seen after external fixator treatment?Methods During a 2-year period, 11 centers recruited 27 patients 18 years or older who were included and evaluated at 2 and 6 weeks and at 3, 6, and 12 months after surgery as part of this prospective case series. During the study period, the participating centers agreed on general indications for use of the hinged external fixator, which included persistent instability after closed reduction alone or closed reduction combined with surgical treatment of associated fracture(s), when indicated. Functional outcome was evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH; primary outcome) score, the Mayo Elbow Performance Index (MEPI), the Oxford Elbow Score, and the level of pain (VAS). ROM, adverse events, secondary interventions, and radiographs also were evaluated. A total of 26 of the 27 patients (96%) were available for followup at 1 year.The institution of one or more of the authors (GITI, DDH, EMMVL, PP, MHJV) has received, during the study period, funding from the Osteosynthesis and Trauma Care ( Results All functional and pain scores improved. The median QuickDASH score decreased from 30 (25 th -75 th percentiles [P 25 -P 75 ], 23-40) at 6 weeks to 7 (P 25 -P 75 , 2-12) at 1 year with a median difference of À25 (p \ 0.001). The median MEPI score increased from 80 (P 25 -P 75 , 64-85) at 6 weeks to 100 (P 25 -P 75 , 85-100) at 1 year with a median difference of 15 (p \ 0.001). The median Oxford Elbow Score increased from 60 (P 25 -P 75 , 44-68) at 6 weeks to 90 (P 25 -P 75 , 73-96) at 1 year with a median difference of 29 (p \ 0.001). The median VAS decreased from 2.8 (P 25 -P 75 , 1.0-5.0) at 2 weeks to 0.5 (P 25 -P 75 , 0.0-1.9) at 1 year with a median difference of À2.1 (p = 0.001). ROM also improved. The median flexionextension arc improved from 50°(P 25 -P 75 , 33°-80°) at 2 weeks to 118°(P 25 -P 75 , 105°-138°) at 1 year with a median difference of 63°(p \ 0.001). Similarly, the median pronation-supination arc improved from 90°(P 25 -P 75 , 63°-124°) to 160°(P 25 -P 75 , 138°-170°) with a median difference of 75°(p \ 0.001). At 1 year, the median residual deficit compared with the uninjured side was 30°( P 25 -P 75 , 5°-35°) for the flexion-extension arc, and 3°( P 25 -P 75 , 0°-25°) for the pronation-supination arc. Ten patients (37%) experienced a fixa...

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“…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%

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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Simple elbow dislocation among adults: A comparative study of two different methods of treatment

Cited by 111 publications

References 14 publications

Results of Closed Reduction and Early Rehabilitation in Simple Elbow Dislocations

Results of Closed Reduction and Early Rehabilitation in Simple Elbow Dislocations

Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

Cost analysis and outcomes of simple elbow dislocations

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