Interventions for treating acute elbow dislocations in adults.

Area of Science:

• Orthopedic Surgery
• Traumatology
• Evidence-Based Medicine

Background:

• Elbow joint dislocations are relatively uncommon injuries in adults.
• Determining optimal treatment strategies for acute simple elbow dislocations is crucial for patient outcomes.

Purpose of the Study:

• To assess the effects of various treatments for acute simple elbow dislocations in adults.
• To evaluate conservative versus surgical interventions for elbow dislocations.

Main Methods:

• Systematic search of multiple databases including Cochrane, MEDLINE, EMBASE, PEDro, and CINAHL up to April 2011.
• Inclusion of randomized or quasi-randomized controlled trials comparing conservative and surgical treatments for adult elbow dislocations.
• Exclusion of trials involving dislocations with associated fractures, except for avulsion fractures.

Main Results:

• Two small, methodologically flawed randomized controlled trials (RCTs) involving 80 participants were included.
• One trial comparing early mobilization versus cast immobilization showed a trend towards better range of motion with early mobilization, but results were not statistically significant.
• Another trial comparing surgical ligament repair versus conservative treatment found no significant differences in long-term function, patient-reported outcomes, or range of motion.

Conclusions:

• Insufficient evidence exists from RCTs to definitively recommend a treatment for simple adult elbow dislocations.
• Available evidence does not support surgical ligament repair over conservative treatment for improving long-term function.
• Future research should investigate non-surgical treatment aspects, such as optimal immobilization duration.