title: Conservative management of elbow dislocations with an overhead motion protocol.
abstract: OBJECTIVE
  To report the results of using an overhead motion protocol in 27 patients and to assess final range of motion and incidence of persistent instability in this cohort.
  
  
  METHODS
  A total of 27 patients were included who sustained a simple elbow dislocation and were treated nonsurgically with an overhead motion protocol designed to convert gravity from a distracting to a stabilizing force. Motion was initiated within 1 week of injury and average follow-up was 29 months. Final arc of motion and prevalence of instability were the primary outcomes measures.
  
  
  RESULTS
  Final mean arc of extension to flexion was from 6° to 137°, and of pronation to supination was from 87° to 86°. No recurrent instability was observed in this cohort and all patients were fully functional and without limitations at latest follow-up.
  
  
  CONCLUSIONS
  The overhead motion protocol was a reliable rehabilitation program after elbow dislocation that allowed for controlled early motion by placing the elbow in an inherently stable position. Prompt initiation of motion in a protected position can optimize final motion and satisfaction outcomes, and when done in a mechanically advantageous position it can potentially limit the risk of recurrent instability.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Schreiber
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
authors.forename: Sophia
authors.initials: S
authors.lastname: Paul
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Hotchkiss
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY. Electronic address: daluiskia@hss.edu.
authors.forename: Aaron
authors.initials: A
authors.lastname: Daluiski
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D007593:Joint Instability / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000379:methods*; D011403:Pronation / Q000502:physiology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D013484:Supination / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries
keywords: Elbow dislocation; overhead motion; rehabilitation