The level of evidence is downgraded by study limitations (several issues) and imprecise results (wide confidence intervals).
Early mobilization is suggested for simple dislocations of the elbow in adults.
A Cochrane review [Abstract] 1 included 2 studies with a total of 80 subjects.
One trial, involving 50 participants, compared early mobilisation at three days post reduction versus cast immobilisation. At one year follow-up, the recovery of range of motion appeared better in the early mobilisation group (e.g. participants with incomplete recovery of extension: 1/24 versus 5/26; RR 0.22, 95% Cl 0.03 to 1.72) but results were not statistically significant. There were no reports of instability or recurrence. One person in each group had residual pain at one year.
The other trial, involving 30 participants, compared surgical repair of the torn ligaments versus conservative treatment (cast immobilisation for two weeks). At final follow-up (mean 27.5 months), there were no statistically significant differences between the two groups in the numbers of patients who considered their injured elbow to be inferior to their non-injured elbow (10/14 versus 7/14; RR 1.43, 95% CI 0.77 to 2.66) or in other patient complaints about their elbow such as weakness, pain or weather-related discomfort. There were no reports of instability or recurrence. There were no statistically significant differences between the two groups in range of motion of the elbow (extension, flexion, pronation, and supination) or grip strength at follow-up. No participants had neurological disturbances of the hand but two surgical group participants had recurrent dislocation of the ulnar nerve (no other details provided). One person in each group had radiologically detected myositis ossificans (bone formation within muscles following injury).
Date of latest search: 2011-07-01
Primary/Secondary Keywords