Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial

Iordens, G.I.T.; Lieshout, Esther M.M. Van; Schep, N.W.L.; Haan, Jos de; Tuinebreijer, W.E.; Eygendaal, Denise; Beeck, Ed van; Patka, P.; Verhofstad, Michael H J; Hartog, Dennis den

doi:10.1136/bjsports-2015-094704

Cited by 70 publications

(64 citation statements)

References 26 publications

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“…The FuncSiE trial compared clinical outcome of early mobilization and plaster immobilization in patients with a simple elbow dislocation. The results of this study showed that early mobilization resulted in earlier recovery of elbow function and work resumption [12].…”

Section: Introductionmentioning

confidence: 62%

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Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial

Lieshout

Iordens

Polinder

et al. 2019

Arch Orthop Trauma Surg

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Introduction The primary aim was to assess and compare the total costs (direct health care costs and indirect costs due to loss of production) after early mobilization versus plaster immobilization in patients with a simple elbow dislocation. It was hypothesized that early mobilization would not lead to higher direct and indirect costs. Materials and methods This study used data of a multicenter randomized clinical trial (FuncSiE trial). From August 25, 2009 until September 18, 2012, 100 adult patients with a simple elbow dislocation were recruited and randomized to early mobilization (immediate motion exercises; n = 48) or 3 weeks plaster immobilization (n = 52). Patients completed questionnaires on health-related quality of life [EuroQoL-5D (EQ-5D) and Short Form-36 (SF-36 PCS and SF-36 MCS)], health care use, and work absence. Follow-up was 1 year. Primary outcome were the total costs at 1 year. Analysis was by intention to treat. Results There were no significant differences in EQ-5D, SF-36 PCS, and SF-36 MCS between the two groups. Mean total costs per patient were €3624 in the early mobilization group versus €7072 in the plaster group (p = 0.094). Shorter work absenteeism in the early mobilization group (10 versus 18 days; p = 0.027) did not lead to significantly lower costs for loss of productivity (€1719 in the early mobilization group versus €4589; p = 0.120). Conclusion From a clinical and a socioeconomic point of view, early mobilization should be the treatment of choice for a simple elbow dislocation. Plaster immobilization has inferior results at almost double the cost.

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Section: Introductionmentioning

confidence: 62%

“…The trial is registered at the Netherlands Trial Register (NTR2025). The results of this study and the study protocol can be read elsewhere [12,13]. The study was approved by the Medical Research Ethics Committee.…”

Section: Settings and Participantsmentioning

confidence: 99%

Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial

Lieshout

Iordens

Polinder

et al. 2019

Arch Orthop Trauma Surg

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“…After early mobilization and fixation with a cast after reduction, the time taken for returning to the job was 10 and 18 days, respectively, in the study by Iordens et al (14), but 3.2 and 6.6 days, respectively, in the study by Maripuri et al (9) In our study, patients returned to their jobs after 12 days (range, 10-16 days) on average. In the literature, the rate of repeating dislocation after simple elbow dislocations is 0.6%.…”

Section: Discussionmentioning

confidence: 64%

“…In a study comparing early mobilization and immobilization after reduction, it was statistically demonstrated that the joint range of motion in the 6 th week was to be better in the early mobilization group, but the results were similar at the end of the 1 st year (14). In 43 simple elbow dislocations that were retrospectively evaluated by De Haan et al (11), while a mean flexion degree of 141.0° was obtained in the long term, a mean extension loss of 5.5° was detected.…”

Section: Discussionmentioning

confidence: 99%

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Results of Closed Reduction and Early Rehabilitation in Simple Elbow Dislocations

Ataoğlu¹,

Ayanoğlu²,

Elshan³

et al. 2017

JAREM

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Objective: To share the outcomes of closed reduction and early mobilization in patients with simple elbow dislocation.Methods: From 2008 to 2015, 18 adult patients with simple elbow dislocations were enrolled in the Emergency Department of our hospital. All the patients received closed reduction under sedation. After reduction, a long arm cast was applied to all patients for one week. Early active movement was begun at the end of this week. Patients were not allowed to do passive stretching exercises for three weeks. All patients were followed up at the first week, sixth week and first year. Patients were evaluated both radiographically and functionally with Quick-DASH and Oxford Elbow Score. The results were evaluated by comparison with patients' contralateral elbow.Results: Quick-DASH scores at 1 year were 5.0 in the dislocation group versus 4.0 in the contralateral elbow. Oxford Elbow Scores at 1 year were 91 in the dislocation group versus 95 in the contralateral elbow. There was no significant relationship between the two groups at the first year controls (p>0.05). There was no significant difference in terms of range of motion (p>0.05). Patients returned to work sooner after early mobilization (average of 12 days). No recurrent dislocations occurred. After one year, there was no significant deterioration with radiographic joint integrity in any patient. Conclusion:Early active mobilization is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier compared to plaster immobilization.

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A novel mouse model of hindlimb joint contracture with 3D‐printed casts

Moore

Lee

Agha

et al. 2022

Journal Orthopaedic Research

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Stiff joints formed after trauma, surgery or immobilization are frustrating for surgeons, therapists and patients alike. Unfortunately, the study of contracture is limited by available animal model systems, which focus on the utilization of larger mammals and joint trauma. Here we describe a novel mouse‐based model system for the generation of joint contracture using 3D‐printed clamshell casts. With this model system we are able to generate both reversible and irreversible contractures of the knee and ankle. Four‐ or 8‐month‐old female mice were casted for either 2 or 3 weeks before liberation. All groups formed measurable contractures of the knee and ankle. Younger mice immobilized for less time formed reversible contractures of the knee and ankle. We were able to generate irreversible contracture with either longer immobilization time or the utilization of older mice. The contracture formation translated into differences in gait, which were detectable using the DigiGait® analysis system. This novel model system provides a higher throughput, lower cost and more powerful tool in studying the molecular and cellular mechanisms considering the large existing pool of transgenic/knockout murine strains.

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Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial

Abstract: NTR 2025.

Cited by 70 publications

References 26 publications

Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial

Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial

Results of Closed Reduction and Early Rehabilitation in Simple Elbow Dislocations

A novel mouse model of hindlimb joint contracture with 3D‐printed casts

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