Unstable simple elbow dislocations: medium-term results after non-surgical and surgical treatment
Purpose: Determination of the appropriate treatment of unstable simple elbow dislocations is difficult and a topic of ongoing discussion. The aim of this study was to analyse the outcome and complications after surgery and conservative treatment, with special focus on post-traumatic joint laxity. Me...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article (Journal) |
| Language: | English |
| Published: |
2017
|
| In: |
Knee surgery, sports traumatology, arthroscopy
Year: 2017, Volume: 25, Issue: 7, Pages: 2271-2279 |
| ISSN: | 1433-7347 |
| DOI: | 10.1007/s00167-016-4100-7 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1007/s00167-016-4100-7 Verlag, Volltext: https://link.springer.com/article/10.1007/s00167-016-4100-7 
|
| Author Notes: | Marc Schnetzke, Sara Aytac, Holger Keil, Moritz Deuss, Stefan Studier-Fischer, Paul-Alfred Grützner, Thorsten Guehring |
| Summary: | Purpose: Determination of the appropriate treatment of unstable simple elbow dislocations is difficult and a topic of ongoing discussion. The aim of this study was to analyse the outcome and complications after surgery and conservative treatment, with special focus on post-traumatic joint laxity. Methods: In this retrospective study, 118 consecutive patients with simple elbow dislocations underwent stability testing by fluoroscopy after joint reduction and were assigned to groups 1 (slight), 2 (moderate) or 3 (gross) depending on post-traumatic joint laxity. All patients of group 1 underwent conservative treatment, and of group 3 primary ligament repair. In patients with moderate elbow laxity, the treatment was decided individually. All patients underwent a similar functional rehabilitation programme during treatment. Clinical outcome was determined after an average of 3.4 ± 1.5 years using the Mayo Elbow Performance Score (MEPS), and treatment-associated complications and revisions were recorded. Results: Forty-nine patients (41.5 %) were assigned to group 1, 41 patients (34.7 %) to group 2 and 28 patients (23.7 %) to group 3. In group 2, 22 patients underwent ligament repair, while 19 patients were treated conservatively. On average, an excellent MEPS was achieved in group 1 after conservative treatment (MEPS 95.8 ± 9.0), similar to results after ligament repair of grossly unstable elbows in group 3 (91.6 ± 11.7). Interestingly, in group 2 conservative treatment was associated with a slightly lower MEPS (90.0 vs. 95.7), and significantly fewer patients achieved an excellent MEPS (81.8 vs. 52.6 %, p = 0.045). Similarly, conservative treatment in group 2 was associated with a fivefold to sixfold risk of complications (p = 0.032) and revision surgery (p = 0.023). Conclusions: This study supports the notion that patients with slight elbow laxity can be treated non-operatively, while primary surgical treatment should be performed in patients with moderate and gross laxity to avoid post-traumatic sequelae and decrease revision rates. Level of evidence: Retrospective: Cohort Study, Level III. |
|---|---|
| Item Description: | Published online: 4 April 2016 Gesehen am 04.07.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1433-7347 |
| DOI: | 10.1007/s00167-016-4100-7 |