title: Residual subluxation of the elbow after dislocation or fracture-dislocation: treatment with active elbow exercises and avoidance of varus stress.
abstract: During a 6-year period, 2 surgeons prescribed active elbow exercises and avoidance of shoulder abduction (varus stress) for 23 patients (15 men, 8 women) with a mean age of 43 years (range, 19-74 years) who had slight residual subluxation of a dislocated elbow after either nonoperative (3 simple dislocations and 2 fracture-dislocations) or operative treatment (18 fracture-dislocations). A stable elbow was achieved in all 23 patients, although 1 patient, treated late, had a very slight residual posterior subluxation of the radial head on radiographs. After a mean of 24 months (range, 12-45 months), the average flexion arc was 113 degrees , with mean flexion of 132 degrees and mean flexion contracture of 20 degrees . The mean Broberg-Morrey score was 90 points (range, 61-100 points). Ratings were excellent in 9 patients, good in 10, and fair in 4. Mild radiographic signs of arthrosis (type 1 Broberg-Morrey) were present in 2 patients. Slight postreduction subluxation of the elbow, without detrimental contact of the articular surfaces, a type of pseudosubluxation of the elbow sometimes referred to as the "drop sign," can be treated with active exercises and avoidance of varus stress.
authors.affiliation: General Surgery Department, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Duckworth
authors.forename: Anna
authors.initials: A
authors.lastname: Kulijdian
authors.forename: Michael D
authors.initials: MD
authors.lastname: McKee
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000534:rehabilitation* / Q000628:therapy; D007593:Joint Instability / Q000209:etiology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011187:Posture; D013314:Stress, Mechanical; D000092464:Elbow Injuries