[Pure posterior luxation of the elbow in adults: immobilization or early mobilization. A randomized prospective study of 50 cases].
BACKGROUND
Pure posterior dislocation of the elbow is frequent in young subjects. The objective of treatment must be to reduce the dislocation and avoid complications, the most frequent being stiffness, but also elbow instability. The objective of this prospective study was to evaluate the functional and anatomical characteristics of two treatment modalities: plaster immobilization and early mobilization.


METHODS
50 cases of pure posterior dislocation of the elbow were included in a prospective study and randomized to two groups: Group I: twenty six cases were treated by reduction under general anaesthesia and plaster immobilization for three weeks, followed by rehabilitation. Group II: twenty four cases were treated by reduction under general anaesthesia, followed by early mobilization.


RESULTS
We evaluated our results in terms of loss of amplitude of elbow movement (particularly extension), stiffness, instability, relapses, pain and ossification. This study demonstrated better recovery of elbow function in patients treated by early mobilization: 96% of good results with recovery of normal extension in group II versus 81% of cases in group I. Stiffness was observed in 19% of patients in group I versus 4% in group II; this difference was very significant. Comparison of pain revealed no significant difference and no relapses, instability or ossifications were observed in either of the two groups.


CONCLUSIONS
Early mobilization is superior to plaster immobilization, as it allows recovery of better quality elbow function without inducing instability or recurrence.
Rafai
M
M
Service de Traumatologie-Orthopédie, CH Ibn Rochd, Casablanca, Maroc.
Largab
A
A
Cohen
D
D
Trafeh
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000209:etiology; D002370:Casts, Surgical; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000517:prevention & control; D004204:Joint Dislocations / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012008:Recurrence; D016896:Treatment Outcome; D000092464:Elbow Injuries
Luxation postérieure pure du coude chez l'adulte: immobilisation ou mobilisation précoce. Etude prospective randomisée sur 50 cas.