Krticka Milan, Ira Daniel, Flek Martin, Svancara Jan, Pikula Radek
Department of Trauma Surgery, University Hospital Brno, Brno, Czech Republic.
Institute of Biostatistics and Analysis, Masaryk University, Brno, Czech Republic.
Indian J Orthop. 2018 Nov-Dec;52(6):584-589. doi: 10.4103/ortho.IJOrtho_578_16.
Elbow dislocation is the second most frequent type of large joint dislocations in adults. Standard treatment of simple elbow dislocation (SED) without manifestation of instability includes closed reduction, short-term immobilization of the elbow followed by functional aftercare. This study evaluates SED treatment, comparing outcomes of conservative functional treatment and surgical therapy.
54 adult patients with SED without manifest instability treated in tertiary hospital between January 2008 and June 2015 were analyzed in this retrospective study. 28 patients were treated conservatively. Closed elbow reduction was followed by short-term plaster splint and active rehabilitation. Twenty six patients underwent closed elbow reduction and subsequent reconstruction of torn collateral ligaments. Postoperatively, plaster splint was applied followed by rehabilitation.
Patients who were treated conservatively reached statistically significant better scores in Quick Disability Arm Shoulder Hand, Oxford Elbow Score, and Mayo Elbow Performance Score. Functional conservative treatment resulted in a higher range of motion. The complication rate was higher in the group of surgically treated patients.
Careful examination of elbow stability after closed reduction of SED is crucial for further therapy. Patients with stable SED should be treated with functional conservative therapy. Surgical collateral ligaments revision and reconstruction are indicated only for patients with manifestation of elbow instability.
肘关节脱位是成人大型关节脱位中第二常见的类型。单纯肘关节脱位（SED）且无不稳定表现的标准治疗方法包括闭合复位、肘关节短期固定，随后进行功能康复治疗。本研究评估了SED的治疗方法，比较了保守功能治疗和手术治疗的效果。
本回顾性研究分析了2008年1月至2015年6月在三级医院接受治疗的54例无明显不稳定表现的成年SED患者。28例患者接受保守治疗。肘关节闭合复位后采用短期石膏夹板固定并积极康复治疗。26例患者接受了肘关节闭合复位及随后的侧副韧带撕裂重建术。术后应用石膏夹板固定并进行康复治疗。
接受保守治疗的患者在快速上肢、肩部和手部功能障碍评分、牛津肘关节评分和梅奥肘关节功能评分方面的得分在统计学上显著更高。功能保守治疗导致更大的活动范围。手术治疗组的并发症发生率更高。
SED闭合复位后仔细检查肘关节稳定性对进一步治疗至关重要。稳定的SED患者应采用功能保守治疗。仅对有肘关节不稳定表现的患者进行手术侧副韧带修复和重建。
