Elbow stability after simple elbow dislocation: Preliminary results following nonoperative vs. surgical ligamentous repair

Abstract

Aim: We aimed to compare the clinical results after ligamentous elbow dislocation between patients treated nonoperatively (group A) and patients who underwent ligamentous repair (group B). Methods: Hospital records were investigated for cases of ligamentous elbow dislocation from January 2015 to December 2018. In total, 30 patients were identified: nine with nonoperative treatment and 21 with surgical ligamentous repair. The range of motion (ROM) including arc of extension/flexion and pronation/supination, valgus instability, and posterolateral rotatory instability were evaluated. The scores of several outcome measures assessing elbow injury were evaluated. Sonographic examination was performed on all patients to evaluate translation under valgus and posterolateral rotatory stress. Results: Overall, 14 patients with simple elbow dislocation (group A n = 5, 46.4 ± 19.3 years, follow-up [FU] 27 ± 12.4 months; group B n = 9, 57.3 ± 21.0 years, FU 36 ± 11.1 months; 4 female patients in each group) were evaluated. No significant difference was seen in extension/flexion and ext/flex-arc although there was a tendency to limited extension (p = 0.07) in group A. A significantly reduced supination (84 ± 15° vs. 77 ± 21°, p = 0.02) was observed regarding the contralateral side in group B. There was no significant difference in the evaluated scores between the groups. A significantly increased medial angulation during ultrasound evaluation was found in group B compared with the contralateral side. Conclusion: There were no significant differences concerning ROM and functional scores between the nonoperative treatment and ligamentous repair groups. On clinical evaluation, a higher rate of sufficiently healed ligaments was found following surgical repair, although this was not reflected in the ultrasound evaluation.