title: Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial.
abstract: OBJECTIVE
  To compare outcome of early mobilisation and plaster immobilisation in patients with a simple elbow dislocation. We hypothesised that early mobilisation would result in earlier functional recovery.
  
  
  METHODS
  From August 2009 to September 2012, 100 adult patients with a simple elbow dislocation were enrolled in this multicentre randomised controlled trial. Patients were randomised to early mobilisation (n=48) or 3 weeks plaster immobilisation (n=52). Primary outcome measure was theQuickDisabilities of the Arm, Shoulder, and Hand (Quick-DASH) score. Secondary outcomes were the Oxford Elbow Score, Mayo Elbow Performance Index, pain, range of motion, complications and activity resumption. Patients were followed for 1 year.
  
  
  RESULTS
  Quick-DASH scores at 1 year were 4.0 (95% CI 0.9 to 7.1) points in the early mobilisation group versus 4.2 (95% CI 1.2 to 7.2) in the plaster immobilisation group. At 6 weeks, early mobilised patients reported less disability (Quick-DASH 12 (95% CI 9 to 15) points vs 19 (95% CI 16 to 22); p<0.05) and had a larger arc of flexion and extension (121° (95% CI 115° to 127°) vs 102° (95% CI 96° to 108°); p<0.05). Patients returned to work sooner after early mobilisation (10 vs 18 days; p=0.020). Complications occurred in 12 patients; this was unrelated to treatment. No recurrent dislocations occurred.
  
  
  CONCLUSIONS
  Early active mobilisation is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier without increasing the complication rate. No evidence was found supporting treatment benefit at 1 year.
  
  
  BACKGROUND
  NTR 2025.
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Gijs I T
authors.initials: GI
authors.lastname: Iordens
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Esther M M
authors.initials: EM
authors.lastname: Van Lieshout
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Niels W L
authors.initials: NW
authors.lastname: Schep
authors.affiliation: Department of Surgery, Westfriesgasthuis, Hoorn, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: De Haan
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Wim E
authors.initials: WE
authors.lastname: Tuinebreijer
authors.affiliation: Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Eygendaal
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Ed
authors.initials: E
authors.lastname: Van Beeck
authors.affiliation: Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Patka
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Michael H J
authors.initials: MH
authors.lastname: Verhofstad
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Dennis
authors.initials: D
authors.lastname: Den Hartog
mesh_terms: D000328:Adult; D002370:Casts, Surgical; D004434:Early Ambulation / Q000379:methods*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D000068958:Return to Sport / Q000502:physiology; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Elbow