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[Elbow dislocation in childhood. Long-term observational study]
G Frongia1, P Günther, P Romero
1Sektion Kinderchirurgie, Chirurgische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, Heidelberg, Germany. giovanni.frongia@gmail.com
Insights
Pediatric elbow dislocations, though rare, typically heal well in children. Most cases show good to excellent outcomes with minimal long-term functional deficits, even with associated fractures.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Sports Medicine
Background:
- Traumatic elbow dislocation is an uncommon injury in children, representing 3-6% of all elbow injuries.
- Limited literature exists on the long-term outcomes of childhood elbow dislocations.
Purpose of the Study:
- To evaluate the clinical outcomes and functional recovery in children treated for acute traumatic elbow dislocation.
- To assess the impact of concomitant fractures on the prognosis of pediatric elbow dislocations.
Main Methods:
- Retrospective study of 33 children treated for acute traumatic elbow dislocation between 2001 and 2008.
- Clinical examination and Mayo Elbow Performance Score assessment after an average follow-up of 4.5 years.
- Analysis of injury patterns, including dislocation type, associated fractures, and treatment interventions.
Main Results:
- 61% of patients were clinically examined post-treatment.
- No joint instabilities were observed, and only minor limitations in range of motion were noted.
- Mayo elbow performance scores were good to excellent for all evaluated children, irrespective of associated fractures.
Conclusions:
- Pediatric traumatic elbow dislocations generally have favorable outcomes with minimal long-term functional limitations.
- Associated fractures do not appear to significantly worsen the functional prognosis after elbow dislocation in children.
- Recurrence rates are low, and joint stability is typically maintained post-treatment.
Abstract:
Traumatic dislocation of the elbow is rare in children with an incidence of 3-6% of all elbow injuries. In the literature the outcome after elbow dislocation in childhood is rarely discussed. In the present study 33 children treated in our clinic from 2001 to 2008 with an acute traumatic dislocation of the elbow were retrospectively included. All events were unilateral whereby 1 child (3%) showed a recurrence of elbow dislocation after 9 weeks, 30% had a pure dislocation, 70% had a concomitant fracture, 55% showed a fracture of the medial epicondyle, 6% a fracture of the lateral epicondyle and 9% a further fracture. Of the fractures 83% required open reduction with osteosynthesis. After an average of 4.5 years 20 children (61%) were clinically examined. There were no instabilities of the joint and only minor clinical limitations of the range of motion. The established Mayo elbow performance score showed good to excellent results for all children. Despite severe joint trauma with frequently accompanying fractures, post-traumatic functional deficits are rarely limiting, independent of the accompanying fracture. The frequency of recurrence is low and instabilities were not seen.
