2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


A Prospective Prevalence and Outcome Study on Simple and Complex Elbow Dislocations

Maciej J K Simon, MD, PhD, Kiel GERMANY
Anna-Marie Merkenschlager, DMD, Kiel GERMANY
Mathis Wegner, MD, Kiel GERMANY
Andreas Seekamp, Prof, Kiel GERMANY

University Medical Center Schleswig-Holstein – Campus Kiel, Department of Orthopaedics and Trauma Surgery, Kiel, GERMANY

FDA Status Not Applicable

Summary

Elbow dislocations have in all collected cases at least one ligament lesion as detected per MRI scan, which are not always clinically noticeable, thus management strategies need be adjusted.

Abstract

Background

Elbow dislocations are the second most common joint dislocation, which can be simple – pure ligamentous lesions – or complex – combined with fractures. Thus, the reconstruction of the bone, ligament and muscle interplay is essential. Most previous studies are retrospective and limited in their data collection.
The aim of this study is to identify the prevalence of the variety of injury patterns after elbow dislocations and its management.

Methods

Inclusion criteria of this on-going prospective, bi-center study are patients between 18 and 80 years of age with an acute elbow dislocation, a clinical and physical examination, and radiological assessment with radiographs, CT and MRI-scans. Patients are treated depending on the injury pattern and stability surgically or conservatively. In addition to the examinations, patients are assessed with patient-reported outcome measures (PROMs) – ASES, DASH, MEPS, PREE, OES and EQ-5D-5L. Follow-up (FU) times are at 6 weeks, 3, 6, 12 and 24 months after injury/surgery.

Results

Currently, eleven patients (36,4±13,7 years, male n=8, female n=3) with elbow dislocations (45% after a sport and 27% due-to a work-related injury) are enrolled in this study. Up-to-date FU times vary between 6-9 months. Seven patients had at least a clinically unidirectional collateral ligament (CL) instability and a concurrent bony fracture. Four patients had no bone fractures but demonstrated clinical CL instability. However, all patients demonstrated according to the MRI scans at least one injury of the CL. The LCL was most often involved.
Nine patients were treated surgically and two non-operatively. All patients received after initial immobilization a hinged brace for 6 weeks. After 3 months, the average ROM was extension/flexion 0-31-132° and pro/supination 86-0-77°. The VAS was significantly reduced from 6.65 down to 1.6. PROMs demonstrate continuous improvements with values of ASES 81.7, DASH 21.6, MEPS 85, OES 35.9 and Eq5d 75.7 at 3 months.

Conclusions

The current data shows that elbow dislocations are mainly occurring in the third to fifth decade and have in all cases at least one ligament lesion as detected per MRI scan. However, CL lesions are not always clinically noticeable, thus the need for an MRI scan is debatable and whether it is needed within the acute post elbow dislocation management. The current study is still recruiting patients and continuously carries out FU examinations, therefore the longer FU times and greater patient numbers will hopefully render more differentiated answers.