title: Cost analysis and outcomes of simple elbow dislocations.
abstract: OBJECTIVE
  To evaluate the management, clinical outcome and cost implications of three different treatment regimes for simple elbow dislocations.
  
  
  METHODS
  Following institutional board approval, we performed a retrospective review of all consecutive patients treated for simple elbow dislocations in a Level I trauma centre between January 2008 and December 2010. Based on the length of elbow immobilisation (LOI), patients were divided in three groups (Group I, < 2 wk; Group II, 2-3 wk; and Group III, > 3 wk). Outcome was considered satisfactory when a patient could achieve a pain-free range of motion ≥ 100° (from 30° to 130°). The associated direct medical costs for the treatment of each patient were then calculated and analysed.
  
  
  RESULTS
  We identified 80 patients who met the inclusion criteria. Due to loss to follow up, 13 patients were excluded from further analysis, leaving 67 patients for the final analysis. The mean LOI was 14 d (median 15 d; range 3-43 d) with a mean duration of hospital engagement of 67 d (median 57 d; range 10-351 d). Group III (prolonged immobilisation) had a statistically significant worse outcome in comparison to Group I and II (P = 0.04 and P = 0.01 respectively); however, there was no significant difference in the outcome between groups I and II (P = 0.30). No statistically significant difference in the direct medical costs between the groups was identified.
  
  
  CONCLUSIONS
  The length of elbow immobilization doesn't influence the medical cost; however immobilisation longer than three weeks is associated with persistent stiffness and a less satisfactory clinical outcome.
authors: Michalis Panteli, Ippokratis Pountos, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level A, Leeds LS1 3EX, United Kingdom.
authors: Michalis
authors: M
authors: Panteli
authors: Michalis Panteli, Ippokratis Pountos, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level A, Leeds LS1 3EX, United Kingdom.
authors: Ippokratis
authors: I
authors: Pountos
authors: Michalis Panteli, Ippokratis Pountos, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level A, Leeds LS1 3EX, United Kingdom.
authors: Nikolaos K
authors: NK
authors: Kanakaris
authors: Michalis Panteli, Ippokratis Pountos, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level A, Leeds LS1 3EX, United Kingdom.
authors: Theodoros H
authors: TH
authors: Tosounidis
authors: Michalis Panteli, Ippokratis Pountos, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level A, Leeds LS1 3EX, United Kingdom.
authors: Peter V
authors: PV
authors: Giannoudis
keywords: Cost analysis; Elbow dislocations; Management; Outcome; Simple