Conservative and surgical management of simple elbow dislocations: SMDA-SEC consensus and guidelines.

Abstract

Purpose: Proper management of simple elbow dislocations is mandatory to avoid elbow stiffness, chronic instability, heterotopic ossification, or deformity of the elbow. The aim of the present study was to perform a systematic review of the current treatments of simple elbow dislocations to identify the best non-surgical and surgical management for patients with simple elbow dislocations (SED).

Methods: A review of the literature was performed according to the PRISMA guidelines. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases was performed using the following keywords: "elbow dislocation", "simple elbow dislocation", "traumatic elbow dislocation", "treatment", "management", "reduction", "rehabilitation", "functional outcome", "range of motion", "complications", "recovery time" over the years 1976-2024.

Results: The literature search and cross-referencing resulted in a total of 345 references, of which 283 were rejected due to off-topic abstract and/or failure to fulfil the inclusion criteria. After reading the remaining full-text articles, we included 60 studies, investigating non-surgical management or surgical management of simple elbow dislocations.

Conclusion: The SMDA-SEC consensus panel provided recommendations to improve the management of patients with SED in clinical practice. Early mobilization is recommended for all cases of simple elbow dislocations. The CMA-EC panel was unable to advise or against the short-period (1-3-wk) immobilization, prolonged (3-wk) immobilization or operative treatment due to insufficient or conflicting evidence.