Dislocations of the elbow in children: long-term follow-up

Abstract

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.

Pure elbow dislocation in the paediatric age group

“…However, there are also studies reported that traumatic posterior dislocation of the elbow was often associated with significant morbidity and incomplete recovery [10]. Extension loss has been demonstrated as the most common sequelae in long-term follow-up [20]. All of the patients evaluated in the current study were treated by closed reduction within the same day of injury and long-arm plaster splint immobilisation for three weeks.…”

“…Possible complications following an elbow dislocation may include residual limitation of the ROM, recurrent instability, neurovascular lesions, avascular necrosis of the epiphyses, heterotopic ossification, radio-ulnar synostosis, and degenerative arthritis in the long-term [6,16,17,20]. The only major complication noted in our study group was loss of extension in four cases diagnosed at the latest follow-up.…”

“…Limited numbers of studies discussing pure elbow dislocation in the paediatric age group have been published in the literature [1,3,7,8,10,16]. Di Gennaro et al [20] reported that dislocation of the elbow in children was a benign injury in the majority of cases and had a good prognosis. On the other hand, Leiber et al [10] concluded that traumatic posterior dislocation of the elbow was often associated with significant morbidity and incomplete recovery.…”

Early Outcomes of Pediatric Elbow Dislocation—Risk Factors Associated With Morbidity

“…They too found extension loss, but good clinical findings and no pain with satisfactory radiographic results. 6 Following reduction of a pediatric ulnohumeral elbow dislocation, it is unclear as to the appropriate duration of immobilization. Previous series have found a positive association between immobilization and stiffness.…”

“…3,4 Previous authors have reported some functional outcome data with regard to pain and flexionextension arc of motion [4][5][6] ; however, the risk factors associated with adverse functional outcomes have not been previously identified.…”