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Dislocations of the elbow in children: long-term follow-up
G L Di Gennaro1, M Spina, M Fosco
1Pediatric Orthopedic Department, Istituto Ortopedico Rizzoli, Via Mascarella 13, Bologna, Italy. gianluigidigennaro@tin.it
Insights
Pediatric elbow dislocations are generally benign, with most adults experiencing no significant long-term issues. While some loss of extension can occur, overall prognosis remains good for these childhood injuries.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Adult Reconstructive Surgery
Background:
- Elbow dislocations in children are typically considered benign injuries.
- This study investigates potential long-term sequelae of pediatric elbow dislocations into adulthood.
- Retrospective evaluation of patients injured before age 15.
Purpose of the Study:
- To assess late complications and functional outcomes of childhood elbow dislocations in adulthood.
- To determine if pediatric elbow injuries impact adult life and career choices.
- To evaluate radiographic evidence of long-term changes.
Main Methods:
- Retrospective review of 40 patients with elbow dislocations before age 15.
- Follow-up conducted after an average of 15 years (range 7-22 years).
- Clinical evaluation and radiographic assessment using Linscheid and Wheeler criteria.
Main Results:
- Few subjective complications reported at long-term follow-up.
- No cases of recurrent dislocation observed.
- Radiographic evaluation showed excellent outcomes in 14 patients, good in 10, and fair in 3.
Conclusions:
- Pediatric elbow dislocations generally have a favorable long-term prognosis into adulthood.
- Ectopic ossifications are common but only large ones correlate with reduced range of motion.
- Loss of extension is the most frequent long-term sequela.
Background:
Dislocation of the elbow in children is considered to be a benign injury in most cases. The aim of this paper is to evaluate whether this condition has late sequelae in the adult age. The study consisted of a retrospective evaluation of patients under 15 years old at the time of injury.
Methods:
40 patients were selected for the follow-up evaluation. The mean age of the children at the time of injury was 10.9 years old (range 5-14 years). Four patients were lost to follow-up, so they were not considered for final clinical evaluation. For the other 36 patients, the follow-up examination was undertaken after an average of 15 years (range 7-22 years). The average age of the patients at the follow-up was 26 (range 18-34 years).
Results:
At the end of follow-up period, there were few subjective complications. No redislocations occurred. None of the patients had been influenced by their elbow injury in their choice of occupation. X-rays were available for 27 patients. These were graded using Linscheid and Wheeler criteria and were excellent in 14 patients, good in 10 and fair in 3.
Conclusions:
Dislocation of the elbow in children is a benign injury in the majority of cases and has a good prognosis in the adult age too in spite of extensive damage to the periarticular structures. Ectopic ossifications are a common finding, but only large periarticular ectopic ossifications were associated with a decrease in range on motion. Extension loss is the most common sequelae. Level of evidence IV.
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