Pincin Antony, Tourtoulou César, Pfirrmann Clémence, Lalioui Abdelfetah, Savidan Pauline, Lefevre Yan, Harper Luke, Angelliaume Audrey
University Hospital of Bordeaux, Pediatric Orthopaedics, Place Amelie Raba-Leon, 33076 Bordeaux, France.
University Hospital of Bordeaux, Pediatric Orthopaedics, Place Amelie Raba-Leon, 33076 Bordeaux, France.
Orthop Traumatol Surg Res. 2025 May;111(3):103538. doi: 10.1016/j.otsr.2022.103538. Epub 2022 Dec 29.
The initial management of elbow dislocations in children, emergency reduction and brachial-antebrachial-palmar (BABP) immobilization, remains the most widely used method. Osteosynthesis could be associated in case of fractures. On the other hand, there is no consensus on the duration of immobilization in the recent literature. The objective of this study was to describe the medium-term functional results of a prospective cohort of children presenting with an elbow dislocation immobilized for 3 weeks, with or without an associated fracture. The hypothesis of this study was that 3 weeks of immobilization was sufficient and made it possible to obtain a satisfactory, rapid functional recovery without residual instability.
All children with an elbow dislocation with or without an associated fracture were included. The dislocation was urgently reduced and subsequent surgery could be indicated in the event of associated injuries. All the children had 3 weeks of immobilization with a BABP cast. Radiological and clinical follow-up was carried out for 2 years. The parameters evaluated were: 3 functional scores and the range of motion (ROM) of the elbow. Clinical or radiological complications were sought.
A total of 50 children were included, the mean age was 10.6 years (± 2.6). Functional score results were "good' or "excellent' at 3 months of follow-up, "excellent' at 6 months and thereafter. The mean limitation in ROM at the last follow-up was 4.7° (± 7.2°) with all ranges combined. Eighty-two percent of children had a mean limitation in ROM of less than 10°. None of the children presented with a recurrence of elbow dislocation and instability.
Immobilization of elbow dislocations for 3 weeks in children confers good medium-term functional results without exposing them to the risk of instability, whether or not the dislocation is associated with a fracture.
II; Prospective cohort study.
儿童肘关节脱位的初始治疗，即急诊复位和臂-前臂-掌侧（BABP）固定，仍然是使用最广泛的方法。骨折情况下可能需要进行骨合成。另一方面，近期文献对于固定时间并未达成共识。本研究的目的是描述一组前瞻性队列中肘关节脱位的儿童，无论有无合并骨折，固定3周后的中期功能结果。本研究的假设是，3周的固定时间足够，能够实现快速且令人满意的功能恢复，且无残留不稳定情况。
纳入所有伴有或不伴有合并骨折的肘关节脱位儿童。脱位均进行了急诊复位，若存在合并损伤则可能需要后续手术。所有儿童均使用BABP石膏固定3周。进行了为期2年的放射学和临床随访。评估的参数包括：3项功能评分以及肘关节的活动范围（ROM）。查找临床或放射学并发症。
共纳入50名儿童，平均年龄为10.6岁（±2.6）。随访3个月时功能评分结果为“良好”或“优秀”，6个月及之后为“优秀”。末次随访时所有活动范围合并后的ROM平均受限为4.7°（±7.2°）。82%的儿童ROM平均受限小于10°。所有儿童均未出现肘关节脱位复发及不稳定情况。
儿童肘关节脱位固定3周可获得良好的中期功能结果，无论脱位是否合并骨折，均不会使其面临不稳定风险。
II级；前瞻性队列研究。
