title: Comparative study of simple and complex open elbow dislocations.
abstract: BACKGROUND
  Open elbow dislocations are rare injuries. Most of the evidence related to these dislocations is found in case reports or in series with closed injuries. We reviewed the experiences of three centers in the treatment of open elbow dislocations.
  
  
  OBJECTIVE
  We compared the results after operative treatment of simple and complex open dislocations in terms of (1) ROM, (2) functional score, and (3) complications.
  
  
  METHODS
  Eighteen patients were retrospectively included in this study: 11 with simple open elbow dislocations and seven with complex open elbow dislocations. Mean age was 40 years. Thirteen were men. Eight patients presented neurovascular injuries. Evaluation included ROM of the elbow and forearm as measured by hand-held goniometer. We then classified the results using the 100-point Broberg and Morrey functional rating index based on ROM, grip strength, elbow stability, and pain. Scores of 95 to 100 were considered excellent, 80 to 94 good, 60 to 79 fair, and less than 60 poor. Complications were recorded. Minimum followup was 6 months (mean, 25 months; range, 6-72 months).
  
  
  RESULTS
  We found no differences between simple and complex open elbow dislocations related to ROM (median flexion/extension: 117° versus 110°, p = 0.12; forearm rotation: 160° versus 170°, p = 0.67). According to the Broberg and Morrey score, four patients had excellent results, five good, and one fair in the simple dislocation group, whereas in the complex dislocation group, four patients had excellent results, two good, and one fair (p = 0.8). No difference in complication rate was found between groups (p = 0.63). All complications in the simple dislocation group were neurovascular. In the complex dislocation group, there was one case of brachial artery occlusion, two cases of heterotopic ossification, one case of infection and nonunion, and one case of infection. No patients had recurrent elbow instability.
  
  
  CONCLUSIONS
  No differences between simple and complex open elbow dislocations were found in terms of ROM, functional results, and rate of complications. Complications in the simple dislocation group were related to neurovascular injuries in contrast to the complex dislocation group where complications were associated with the bony injury.
  
  
  METHODS
  Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
authors: Department of the Hand and Upper Extremity, Instituto de Ortopedia y Traumatología "Dr. Prof. Carlos Ottolenghi", Hospital Italiano de Buenos Aires, Buenos Aires, Argentina, jboretto@hotmail.com.
authors: Jorge G
authors: JG
authors: Boretto
authors: Mario
authors: M
authors: Rodriguez Sammartino
authors: Gerardo
authors: G
authors: Gallucci
authors: Pablo
authors: P
authors: De Carli
authors: David
authors: D
authors: Ring
mesh_terms: D000328:Adult; D000368:Aged; D053587:Arthrometry, Articular; D001696:Biomechanical Phenomena; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005543:Forearm Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D010149:Postoperative Pain / Q000209:etiology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries