Long-term functional outcomes following paediatric traumatic elbow dislocation, a clinical retrospective cohort study
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Nelson Bua1, Sandeep Krishan Nayar2, Gunaratnam Shyamalan3
1Registrar in Trauma & Orthopaedics, Royal Free London NHS Foundation Trust. London, United Kingdom.
Insights
Paediatric traumatic elbow dislocations generally have good long-term outcomes. Early management is key for optimal functional results in children, even with associated fractures.
Area of Science:
- Orthopaedic surgery
- Paediatric trauma
- Clinical outcomes research
Background:
- Paediatric traumatic elbow dislocation affects 6 in 100,000 children annually.
- Prompt treatment is crucial to prevent poor outcomes.
- Long-term functional results are not well-documented with modern tools.
Purpose of the Study:
- To evaluate the long-term clinical and functional outcomes of paediatric traumatic elbow dislocations.
- To assess the impact of management strategies on patient-reported outcomes.
Main Methods:
- Retrospective study of 20 children with acute traumatic elbow dislocations (Feb 2007-Feb 2016).
- Data collected on demographics, management, and complications.
- Functional outcomes assessed using Kim's elbow performance score.
Main Results:
- Mean age 12 years, mean follow-up 8 years.
- Low complication rate: 5% re-dislocation, 5% ulna nerve neurapraxia.
- 80% achieved good/excellent outcomes (Kim's score >75); no poor outcomes reported.
Conclusions:
- Traumatic elbow dislocations in children yield good long-term functional outcomes.
- Appropriate early management is critical for favourable results.
- Outcomes are positive with or without associated fractures.
Background:
Paediatric traumatic elbow dislocation occurs in 6 per 100,000 children per year and if not treated promptly can result in a poor outcome. Despite this, the long-term clinical and functional outcome of these injuries has not been well described using modern patient-reported outcome tools. The aim of our study was present the outcome of these injuries in the long term.
Methods:
Twenty children with an acute traumatic elbow dislocation who presented between February 2007 to February 2016 were included in our study. Patient demographics, management and complications were recorded from the clinical notes. Ten children had associated fractures and were managed surgically, while the remaining were managed with closed reduction and immobilisation. Functional outcomes were assessed with Kim's elbow performance score.
Results:
The mean age was 12 years (7 -15) and follow-up was 8 years (4 - 13). There was one (5%) re-dislocation requiring surgery and one (5%) ulna nerve neurapraxia that resolved within one month. The average Kim's scores were 87.5 (65 - 100) and 77.5 (60 - 100) in the closed reduction and open reduction groups, respectively (P=0.08). 80% (16/20) reported good or excellent outcome with a Kim's score of greater than 75 points with no cases of poor functional outcome reported in our series.
Conclusions:
Traumatic elbow dislocations in children, with or without associated fracture, have a good long-term functional outcome with appropriate early management.
