title: A preliminary report of acute and subacute arthroscopic repair of the radial ulnohumeral ligament after elbow dislocation in the high-demand patient.
abstract: OBJECTIVE
  The purpose of this study was to evaluate functional outcomes, range of motion (ROM), elbow stability, and time to return to full activities after acute and subacute arthroscopic repair of a simple elbow dislocation in high-demand patients.
  
  
  METHODS
  "High-demand patients" were defined as in-season athletes and individuals who required use of both hands for their profession and believed that they could not miss the 6 weeks of work that may be required with conservative treatment in an elbow brace. We retrospectively reviewed 14 consecutive patients with a simple elbow dislocation who underwent arthroscopic repair of the radial ulnohumeral ligament from 2008-2012. Outcomes measures included the Mayo Elbow Performance Score (MEPS), elbow ROM, elbow stability, and time to return to full activities. Each patient was contacted once by telephone to determine the current activity level and presence of any pain or functional limitations.
  
  
  RESULTS
  The mean patient age was 25 years, with telephone follow-up at a mean of 30 months and clinical examination after a minimum of 6 months. The postoperative MEPS was excellent (mean, 99.6; range, 95 to 100) for all 14 patients, and all returned to their preinjury level of function with no restrictions or instability. Final ROM averaged -3° of full extension to greater than 130° of flexion. The mean time to return to full activities in and out of a brace was 2.7 weeks and 6.6 weeks, respectively, in the acute group and 4.6 weeks and 8.9 weeks, respectively, in the subacute group. All patients were satisfied with their outcome.
  
  
  CONCLUSIONS
  Conservative management remains the gold standard for most simple elbow dislocations. We believe that certain high-demand patients may be candidates for acute arthroscopic ligamentous repair. Our preliminary data show that acute arthroscopic repair of the radial ulnohumeral ligament is a safe, effective procedure that restores stability to the elbow and allows patients to quickly return to full activities.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Mississippi Sports Medicine and Orthopaedic Clinic, Jackson, Mississippi, U.S.A.
authors.forename: Randall
authors.initials: R
authors.lastname: Lee Murphy
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.. Electronic address: fsavoie@tulane.edu.
authors.forename: Felix H
authors.initials: FH
authors.lastname: Savoie
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D004550:Elbow; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000503:physiopathology / Q000601:surgery*; D010808:Physical Examination; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries