Table 1 Conservative treatment of simple elbow dislocations
From: Treatment strategies for simple elbow dislocation - a systematic review
Author (Year) | Studydesign (SD) | n | Middle Follow-up (in months) | Intervention (INT) | Control group (CG) | Primary outcome parameters | Secondary outcome parameters | Injuries following dislocation (ruptured ligaments) | Redislocations |
|---|---|---|---|---|---|---|---|---|---|
De Haan, J. (2014) [21] | RCT | 100 | 12 | pressure bandage for 5–7 days and early functional treatment | plaster in 90-degree flexion, neutral position for pro-/supination for 3 weeks | No difference in Quick-DASH, MEPI, OES after 12 months; Quick-DASH after 6 weeks: improved by INT (p < 0.05) | Pain after 1 week: increased in CG (p < 0.05); ROM after 6 weeks: INT: CG = 121°: 102° (p < 0,05); Return to work: INT: CG = 8 d: 18 d (p < 0,05) | - | 0 |
Iordens, G. (2017) [22] | RCT | 100 | 12 | early mobilization (n = 48): 4.0 (95% CI 0.9 to 7.1); at 6 weeks: arc of flexion and extension (121° (95% CI 115° to 127°) | 3 weeks plaster immobilization (n = 52): 4.2 (95% CI 1.2 to 7.2); at 6 weeks: 102° (95% CI 96° to 108°) | Quick-DASH scores at 1 year: 4.0 (95% CI 0.9 to 7.1) points in INT group vs 4.2 (95% CI 1.2 to 7.2) in the CG group | Return to work: INT: CG: 10 vs. 18 d (p = 0,02) | INT:CG in type of dislocation: posterolateral 56/56%, posterior 17/19%, lateral 10/10%, posteromedial 6/6%, medial 0/2% | 0 |
Von Lieshout, E. (2020) [23] | RCT | 100 | 12 | early mobilization (immediate motion exercises; n = 48) | 3 weeks plaster immobilization (n = 52) | - | No significance in health-related quality of life in 1 year follow-up [EuroQoL-5D (EQ-5D: 0,88 (INT) vs. 0,89 (CG)) and Short Form-36 (SF-36 PCS (53 in INT and CG) and SF-36 MCS (55 and 56))], return to work INT: CG: 10: 18 d (p > 0.05) | - | - |
Maripuri (2007) [24] | RCS | 47 | 24–60 | early mobilization | 2 weeks of immobilization | Mean MEPI 83.8 (CG) vs. 96.5 (INT); quick-DASH 12.8 (CG) vs. 2.7 (INT) (p < 0.05) | return to work INT: CG: 6.6 weeks vs. 3.3 weeks | - | 0 |
Mehlhoff (1988) [25] | RCS | 52 | 34 | early mobilization | Immobilization > 24 d | - | - | - | - |
Schippinger (1999) [26] | RCS | 45 | 62 | early mobilization | immobilization > 3 weeks | Morrey Score: 56% excellent, 33% good result with less good results depending on the time of immobilization | Return to work: 36 patients | Patients with additional injuries following dislocation were excluded (e.g.: proc. Coronoideus fracture, lateral/medial avulsion) | - |
Riel (1993) [27] | RCS | 39 | 35–156 | early mobilization | Immobilization 3–4 weeks | - | - | - | 0 |
Eygendaal (2000) [28] | RCS | 50 | 108 | closed reduction of posterolateral dislocation (immobilization for 3 weeks) | residual valgus instability | degeneration in radiographs (ectopic ossification) | - | - |