Complex and Unstable Simple Elbow Dislocations: A Review and Quantitative Analysis of Individual Patient Data
Jeroen de Haan1, Niels Schep2, Wim Tuinebreijer2, Dennis den Hartog*, 2
Identifiers and Pagination:Year: 2010
First Page: 80
Last Page: 86
Publisher ID: TOORTHJ-4-80
Article History:Received Date: 23/10/2009
Revision Received Date: 20/11/2009
Acceptance Date: 20/12/2009
Electronic publication date: 17/12/2010
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
The primary objective of this review of the literature with quantitative analysis of individual patient data was to identify the results of available treatments for complex elbow dislocations and unstable simple elbow dislocations. The secondary objective was to compare the results of patients with complex elbow dislocations and unstable elbow joints after repositioning of simple elbow dislocations, which were treated with an external fixator versus without an external fixator.
Electronic databases MEDLINE, EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials.
Studies were eligible for inclusion if they included individual patient data of patients with complex elbow dislocations and unstable simple elbow dislocations.
The different outcome measures (MEPI, Broberg and Morrey, ASES, DASH, ROM, arthritis grading) are presented with mean and confidence intervals.
The outcome measures show an acceptable range of motion with good functional scores of the different questionnaires and a low mean arthritis score. Thus, treatment of complex elbow dislocations with ORIF led to a moderate to good result. Treatment of unstable simple elbow dislocations with repair of the collateral ligaments with or without the combination of an external fixator is also a good option.
The physician-rated (MEPI, Broberg and Morrey), patient-rated (DASH) and physician- and patient-rated (ASES) questionnaires showed good intercorrelations.
Arthritis classification by x-ray is only fairly correlated with range of motion.
Elbow dislocations are mainly on the non-dominant side.