SIMPLE DISLOCATION OF THE ELBOW - COMPARI SON OF LONG-TERM RESULTS AFTER IMMOBILIZATION AND ACCELERATED MOBILIZATION

From 1976 to 1985 the treatment used for simple dislocation of the elb ow consisted in closed reduction and immobilization for about 3-4 week s. Since 1985, simple dislocation of the elbow has been treated with c losed reduction and immobilization for fewer than 3 days. A group trea ted by immobilization (20 patients) and a group that underwent functio nal treatment (24 patients) were both evaluated with regard to elbow m otion, instability, isometric flexor and extensor strength of the fore arm, and subjective (patient) judgement of the elbow function. An aver age of 8 +/- 5 years after the treatment 39 elbows were re-examined. I n both groups, results were generally good, 22 patients having no resi dual symptoms or signs. However, 17 did have symptoms: 6 patients had a slight (loss of extension < 10-degrees, loss of flexion < 10-degrees ) and 1 patient a moderate decrease in the range of motion (loss of ex tension > 10-degrees). Some instability was found in 5 patients and st rength was slightly decreased in 9. The subjective judgement on their elbow function was very good in 22 patients. At follow-up, no statisti cally significant differences were found between the two groups. The r etrospective study, however, revealed that immobilization for 3-4 week s more than doubled the time of after-treatment, the period of disabil ity of the elbow, and the period of physical rehabilitation. Therefore , an accelerated functional treatment is recommended for the treatment of simple elbow dislocation: this is more effective, takes less time and is more economical.