A Comparative Study of Conservative Functional Treatment versus Acute Ligamentous Repair in Simple Dislocation of the Elbow in Adults

Autor: Milan Krtička, Daniel Ira, Radek Pikula, Martin Flek, Jan Švancara
Rok vydání: 2018
Předmět:
musculoskeletal diseases
medicine.medical_specialty
medicine.medical_treatment
Elbow
simple elbow dislocation MeSH terms: Elbow joint
Collateral ligaments reconstruction
elbow instability
mesh: ligaments articular
mesh: Elbow joint
mesh: dislocations
03 medical and health sciences
joint instability
0302 clinical medicine
lcsh:Orthopedic surgery
medicine
Orthopedics and Sports Medicine
mesh: joint instability
Reduction (orthopedic surgery)
030222 orthopedics
Rehabilitation
business.industry
Standard treatment
030229 sport sciences
musculoskeletal system
ligaments articular
3. Good health
Surgery
body regions
lcsh:RD701-811
medicine.anatomical_structure
functional treatment
Elbow dislocation
Orthopedic surgery
Original Article
simple elbow dislocation
business
Range of motion
Splint (medicine)
dislocations
Zdroj: Indian Journal of Orthopaedics
Indian Journal of Orthopaedics, Vol 52, Iss 6, Pp 584-589 (2018)
ISSN: 1998-3727
0019-5413
DOI: 10.4103/ortho.ijortho_578_16
Popis: Background: Elbow dislocation is the second most frequent type of large joint dislocations in adults. Standard treatment of simple elbow dislocation (SED) without manifestation of instability includes closed reduction, short-term immobilization of the elbow followed by functional aftercare. This study evaluates SED treatment, comparing outcomes of conservative functional treatment and surgical therapy. Materials and Methods: 54 adult patients with SED without manifest instability treated in tertiary hospital between January 2008 and June 2015 were analyzed in this retrospective study. 28 patients were treated conservatively. Closed elbow reduction was followed by short-term plaster splint and active rehabilitation. Twenty six patients underwent closed elbow reduction and subsequent reconstruction of torn collateral ligaments. Postoperatively, plaster splint was applied followed by rehabilitation. Results: Patients who were treated conservatively reached statistically significant better scores in Quick Disability Arm Shoulder Hand, Oxford Elbow Score, and Mayo Elbow Performance Score. Functional conservative treatment resulted in a higher range of motion. The complication rate was higher in the group of surgically treated patients. Conclusions: Careful examination of elbow stability after closed reduction of SED is crucial for further therapy. Patients with stable SED should be treated with functional conservative therapy. Surgical collateral ligaments revision and reconstruction are indicated only for patients with manifestation of elbow instability.
Databáze: OpenAIRE
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