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ELBOW DISLOCATION: THERAPEUTIC CHANCES



Abstract

Elbow dislocations are difficult to treat because of the high incidence of short- (vascular and neurological lesions) and long-term (decreased range of motion and instability) complications. We report the results obtained in 20 elbow dislocations treated with hinged cast tutorisation or hinged external fixator.

We treated 20 patients with an average age of 45 years (range 16– 62 years). The average follow-up was 7 months (range 5–18 months). We divided the patients into two groups: patients treated by a hinged tutor for 4 weeks (group A), patients treated by hinged external fixator, removed after 5 weeks (group B). All the patients were evaluated clinically using the “Mayo elbow performance score” after 3 weeks, 1 month and 1 year.

Results were excellent in six elbows and good in 14; none of the patients had an insufficient or poor score. We observed deficit in prono-supination in three patients and deficit in flexion and extension in six patients; three patients complained of epicondylar pain when carrying something. At the end of the treatment none of the patients complained of instability.

According to our data normal function can be restored after early mobilisation. Our experience suggests that the most important aspect in the choice of treatment is the evaluation of joint stability after reduction. The results obtained with the external fixator are very good in terms of restoring function; the incidence of complications is very low and was equally distributed between the two groups.