Schubert I, Strohm P C, Zwingmann J
Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland.
Klinik für Orthopädie und Unfallchirurgie, Klinikum, Albert-Ludwigs-Universität, Freiburg i. Br., Deutschland.
Unfallchirurg. 2019 May;122(5):364-368. doi: 10.1007/s00113-018-0576-6.
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.
The purpose of the study was to review the literature and to derive a recommendation for the best treatment concept.
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.
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).
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.
儿童单纯性肘关节脱位较为罕见。然而，它们具有高度相关性，因为可能导致后续损伤和活动范围受限。治疗方案存在争议。
本研究旨在回顾文献并得出最佳治疗方案的建议。
通过Ovid Medline进行系统的文献检索，共识别出1645篇出版物（最初未针对年龄进行特定筛选），并逐步进行评估。其中四篇出版物符合作者的纳入标准。分析采用描述性分析和荟萃分析。
纳入的4篇出版物描述了81例儿童（≤16岁）的单纯性肘关节脱位。加权平均年龄为9.9岁，男女比例为3.8（男：女）。中位随访时间为49个月。后脱位和后外侧脱位最为常见，占73%。69例患儿接受保守治疗，其中66例在闭合复位后固定超过2周。12例接受手术治疗的患儿脱位时间超过3周未复位。保守治疗固定组的成功率为88%，保守治疗未固定组为70%，手术组为42%。治疗方法成功率之间的差异具有统计学意义（p = 0.032）。
儿童单纯性肘关节脱位罕见。最常见于后脱位和后外侧脱位。预后良好；然而，及时诊断和正确复位对于良好的预后至关重要。
