Abstract
Introduction
The elbow is the second most common site of non prosthetic joint dislocation. Simple elbow dislocation alone contributes to 11-28% of all elbow injuries. Post-reduction treatment methods include traditional plaster of Paris (POP) immobilisation followed by physiotherapy, sling application followed by early mobilisation and rapid motion. The aim of the study was to evaluate the final outcome and cost-effectiveness of the pop and the sling groups.
Study Design
Retrospective cohort study
Methods
We reviewed 42 simple elbow dislocations treated between 1998-2003. 20 patients in POP group and 22 patients in the sling group were assessed at a minimum follow-up of two years. The data collected consisted of age, gender, duration of immobilisation, length of physiotherapy, and return to work. All were assessed using MEPI (Mayo Elbow Performance Index) score and Quick DASH questionnaire. The final outcome was graded as excellent, good, fair and poor.
Results
The final functional outcome in the POP group was 10 excellent, 3 good, 4 fair and 3 poor. In the sling group, we had 19 excellent, 1 good and 2 fair results. The mean MEPI scores in the POP and sling group were 89.2 and 98.2 respectively (p<0.05). The mean quick DASH scores in the POP and sling group were 12.8 and 2.7 respectively (p<0.05). The final functional outcome is directly dependent on the length of immobilisation (R=0.91). The mean time to return to work in POP group and sling groups was 6.6 and 3.2 weeks respectively (p<.001).
Conclusion
Sling and early mobilisation is a safe and cost-effective method of treatment for simple elbow dislocation. The length of physiotherapy and time taken to return to work were significantly shorter in the sling group. Early mobilisation did not result in redislocation or late instability. The final outcome of the sling and early mobilisation group was significantly better than POP immobilisation group.
