I Schubert1, P C Strohm2, J Zwingmann3. 1. Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland. ilona.schubert@sozialstiftung-bamberg.de. 2. Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland. 3. Klinik für Orthopädie und Unfallchirurgie, Klinikum, Albert-Ludwigs-Universität, Freiburg i. Br., Deutschland.
Abstract
BACKGROUND: Simple elbow dislocations in childhood are rare. Nevertheless, they have a high relevance because they can result in subsequent damage and limitations in range of motion. The treatment options are controversially discussed. AIM: The purpose of the study was to review the literature and to derive a recommendation for the best treatment concept. MATERIAL AND METHODS: A systematic literature search was performed via Ovid Medline, whereby 1645 publications were identified (initially nonspecific for age) and evaluated in a stepwise approach. Of these publications four met the inclusion criteria of the authors. The analysis was carried out descriptively and in a meta-analysis. RESULTS: The 4 publications included described simple elbow dislocations in 81 children (≤16 years). The weighted average age was 9.9 years with a gender ratio of 3.8 (boys:girls). The median follow-up was 49 months. Posterior and posterolateral dislocations were the most common with 73%. In 69 children the treatment was conservative and of these 66 were immobilized for longer than 2 weeks after closed reduction. The 12 children who had surgical treatment suffered dislocations that had not been reduced for longer than 3 weeks. The success rate of the conservatively treated immobilized group was 88%, of the conservatively treated non-immobilized group 70% and of the surgical group 42%. The differences between the success rates of the treatment methods was significant (p = 0.032). CONCLUSION: Simple elbow dislocations in children are rare. They most commonly occur in posterior and posterolateral directions. The prognosis is favorable; however a timely diagnosis and correct reduction are relevant for a good outcome.
BACKGROUND: Simple elbow dislocations in childhood are rare. Nevertheless, they have a high relevance because they can result in subsequent damage and limitations in range of motion. The treatment options are controversially discussed. AIM: The purpose of the study was to review the literature and to derive a recommendation for the best treatment concept. MATERIAL AND METHODS: A systematic literature search was performed via Ovid Medline, whereby 1645 publications were identified (initially nonspecific for age) and evaluated in a stepwise approach. Of these publications four met the inclusion criteria of the authors. The analysis was carried out descriptively and in a meta-analysis. RESULTS: The 4 publications included described simple elbow dislocations in 81 children (≤16 years). The weighted average age was 9.9 years with a gender ratio of 3.8 (boys:girls). The median follow-up was 49 months. Posterior and posterolateral dislocations were the most common with 73%. In 69 children the treatment was conservative and of these 66 were immobilized for longer than 2 weeks after closed reduction. The 12 children who had surgical treatment suffered dislocations that had not been reduced for longer than 3 weeks. The success rate of the conservatively treated immobilized group was 88%, of the conservatively treated non-immobilized group 70% and of the surgical group 42%. The differences between the success rates of the treatment methods was significant (p = 0.032). CONCLUSION: Simple elbow dislocations in children are rare. They most commonly occur in posterior and posterolateral directions. The prognosis is favorable; however a timely diagnosis and correct reduction are relevant for a good outcome.
Entities:
Keywords:
Immobilization; Joint instability; Orthopedic procedures; Range of motion, articular; Time factors