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单纯性肘关节脱位的保守与手术治疗:SMDA-SEC共识与指南

Conservative and surgical management of simple elbow dislocations: SMDA-SEC consensus and guidelines.

作者信息

Lu Shengdi, Shen Yun, Wang Yanmao, Yu Shiyang, Zhong Biao, Wang Wei, Lu Jiuzhou, Zhuang Chengyu, Cai Ming, Wu Xiaoming, Yang Chunxi, Yi Chengqing, Wang Zimin, Ding Jian, Fan Cunyi

机构信息

Department of Orthopedics Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.

Pennington Biomedical Research Center.

出版信息

Orthop Rev (Pavia). 2025 Apr 29;17:133988. doi: 10.52965/001c.133988. eCollection 2025.

Abstract

PURPOSE

Proper management of simple elbow dislocations is mandatory to avoid elbow stiffness, chronic instability, heterotopic ossification, or deformity of the elbow. The aim of the present study was to perform a systematic review of the current treatments of simple elbow dislocations to identify the best non-surgical and surgical management for patients with simple elbow dislocations (SED).

METHODS

A review of the literature was performed according to the PRISMA guidelines. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases was performed using the following keywords: "elbow dislocation", "simple elbow dislocation", "traumatic elbow dislocation", "treatment", "management", "reduction", "rehabilitation", "functional outcome", "range of motion", "complications", "recovery time" over the years 1976-2024.

RESULTS

The literature search and cross-referencing resulted in a total of 345 references, of which 283 were rejected due to off-topic abstract and/or failure to fulfil the inclusion criteria. After reading the remaining full-text articles, we included 60 studies, investigating non-surgical management or surgical management of simple elbow dislocations.

CONCLUSION

The SMDA-SEC consensus panel provided recommendations to improve the management of patients with SED in clinical practice. Early mobilization is recommended for all cases of simple elbow dislocations. The CMA-EC panel was unable to advise or against the short-period (1-3-wk) immobilization, prolonged (3-wk) immobilization or operative treatment due to insufficient or conflicting evidence.

摘要

目的

正确处理单纯性肘关节脱位对于避免肘关节僵硬、慢性不稳定、异位骨化或肘关节畸形至关重要。本研究的目的是对单纯性肘关节脱位的当前治疗方法进行系统评价,以确定单纯性肘关节脱位(SED)患者的最佳非手术和手术治疗方案。

方法

根据PRISMA指南进行文献综述。使用以下关键词对PubMed、Medline、CINAHL、Cochrane、Embase和谷歌学术数据库进行全面检索:“肘关节脱位”、“单纯性肘关节脱位”、“创伤性肘关节脱位”、“治疗”、“管理”、“复位”、“康复”、“功能结果”、“活动范围”、“并发症”、“恢复时间”,检索时间跨度为1976年至2024年。

结果

文献检索和交叉引用共得到345篇参考文献,其中283篇因主题不符摘要和/或未满足纳入标准而被排除。阅读其余全文后,我们纳入了60项研究,这些研究调查了单纯性肘关节脱位的非手术治疗或手术治疗。

结论

SMDA-SEC共识小组提供了建议,以改善临床实践中SED患者的管理。建议对所有单纯性肘关节脱位病例进行早期活动。由于证据不足或相互矛盾,CMA-EC小组无法对短期(1-3周)固定、长期(3周)固定或手术治疗提出建议或反对意见。

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