Elbow Dislocations in Contact Sports

Early functional mobilization for non-operative treatment of simple elbow dislocations: a systematic review

PURPOSE

This systematic review aims to elucidate a non-operative rehabilitation program that optimizes recovery based on published approaches and outcomes.

METHODS

Searches of four databases from inception to 1 January 2020 were performed to identify clinical studies addressing the non-operative management of simple elbow dislocations.

RESULTS

Of 2435 studies that were eligible for title screen, 15 studies satisfied inclusion criteria. Three randomized control studies demonstrated that early mobilization expedited the return of range of motion, function and return to work or activities, however, resulted in increased pain within the six-week rehabilitation period compared to Plaster of Paris casting for 21 days. Patients returned to work sooner after early mobilization (10 vs. 18 days; p = 0.02) compared to Plaster of Paris casting. In all studies, early mobilization resulted in similar re-dislocation rates of 1.3% (3/237) versus 2.2% (12/549) in those with Plaster of Paris casting as well as lower incidence of heterotopic ossification (36% vs. 54%). No significant differences between rehabilitation protocols were determined; however, the large majority of recent papers utilized rehabilitation protocols.

CONCLUSION

Early mobilization of simple elbow dislocations results in early return of Range-of-Motion, function and return to work with no increase in complication rates; however, increased pain during the rehabilitation period.

Elbow Dislocations in the National Football League: Epidemiology and Management

Background Currently, it is not known how the combined osseous and ligamentous injury of a traumatic elbow dislocation in a National Football League (NFL) athlete affects management and return to play. In this study, we aimed to describe the epidemiology, management, and return to play for elbow dislocations in NFL athletes. Methodology This is a descriptive observational study. A retrospective review of all elbow dislocations between 2000 and 2014 (15 seasons) was performed using the NFL Injury Surveillance System (NFLISS). Results Over 15 NFL seasons, 82 elbow dislocations were recorded in the NFLISS. Among players who reported surgery (n = 5), players missed an average of 73.8 days of play. Among those who did not report surgery, players missed an average of 36.1 days. The overall incidence was 0.26 dislocation events per 10,000 athlete exposures. The majority of these injuries occurred during regular-season games, in defensive linebackers and linemen, during tackling contact with another player, and most commonly on a running play. Conclusions This study demonstrates that an elbow dislocation is not a career-ending or season-ending injury in an NFL cohort. Information regarding incidence, positions affected, whether surgical management is utilized, and return to play will help players who sustain and physicians who treat these injuries in elite football athletes understand the impact of their injuries.

An Update on Simple Elbow Dislocations: A Protocol for Early Return to Sport in High School Wrestlers

ABSTRACT

The principles and management of simple elbow dislocations have evolved over time. In the past, a conservative approach of immobilization and slow rehabilitation were used. More modern treatments emphasize an understanding of the soft tissues about the elbow joint and prescribe an aggressive approach to regaining motion. Elbow stiffness is a common effect of the injury. We outline our treatment principles in a series of high school wrestlers with simple elbow dislocation. The ultimate goal is to return to sport in a safe but early timeframe. We recommend a brief period of immobilization with close follow-up and no motion restrictions after immobilization is removed. This review and case series emphasize the importance of aggressive but safe return to sport in high school wrestlers with an elbow dislocation.

Elbow Dislocation

This article is a brief overview of the elbow dislocations focusing on updates in treatment and rehabilitation protocols. The fight between obtaining elbow stability without leading to long-term elbow stiffness has been a continued focus in field of sports medicine. This article highlights advances made to help treat the injuries appropriately and obtain optimal patient outcomes.

Current Approach to the Management of Forearm and Elbow Dislocations in Children

Pediatric orthopedic injuries are a common reason for presentation to the emergency department. This article sequentially discusses 2 important upper extremity injuries that require prompt management in the emergency department. Radial head subluxations are discussed with a focus on current evidence for imaging, reduction techniques, and follow-up. Elbow dislocations, although less common than radial head subluxations, are also addressed, highlighting imaging, reduction, immobilization, and follow-up recommendations.