Results of standardized treatment of elbow fracture dislocations as per their injury pattern: a retrospective cohort of 89 patients
Date
2021
Type:
Article
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Abstract
Background: Elbow fracture dislocations represent difficult injuries to treat, with a high percentage ofcomplications. Classically, they are divided into posterolateral, posteromedial and transulnar pattern. It isessential to distinguish them to guide intraoperative treatment to achieve an anatomic and stablereduction that allows early mobility.
Methods: A retrospective study of 89 adult patients diagnosed with elbow fracture dislocations whounderwent a standardized surgery between 2013 and 2018 with a minimum follow-up of 12 months. Demographic data, characteristics of the injury, and associated procedures were collected. Patients wereevaluated with functional scores (Mayo elbow performance score/Broberg and Morrey score) and ranges
of movement at the end of the follow-up.
Results: The mean age was 41 ± 12 years, mostly men (82%), with an average follow-up of 29 months.
We present 42 patients with posterolateral fracture dislocation (47%), 21 posteromedial (24%) and 26 transulnar (29%). The average range of motion at the end of follow-up was 12 ± 11 extension, 124 ± 20 flexion, 76 ± 16 pronation, and 73 ± 20 supination, with a Mayo elbow performance score of 88.7 ± 12 points and 87.2 ± 12 points in the Broberg and Morrey scale. Reoperation rate was 23%, with no infection or heterotopic ossification cases. Transulnar fracture dislocations have significantly worse extension and
supination. As per the functional result (Mayo elbow performance score/Broberg and Morrey scale), there are no significant differences between the different patterns.
Conclusion: Proper injury pattern recognition and a standardized surgical management lead to a stable joint and good results in range of motion. Functional results are encouraging at least at short term, despite the high reoperations rate.
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Citation
Reinares F, Rojas N, Calvo A, Aravena C, Rieutord JP, Callejas O, Montegu R, Paccot D. Results of standardized treatment of elbow fracture dislocations as per their injury pattern: a retrospective cohort of 89 patients. JSES Int. 2021 Feb 9;5(3):588-596. doi: 10.1016/j.jseint.2020.12.004
Keywords
Elbow fracture dislocations, Elbow instability, Clinical outcomes, Elbow terrible triad, Coronoid fracture, Transulnar fracture, Workers compensation