Functional outcomes and complications of open elbow dislocations.

IF 0.5 Q4 ORTHOPEDICS

Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand Pub Date : 2018-01-01 Epub Date: 2018-06-11 DOI:10.1007/s11678-018-0466-0

Marc Schnetzke, Felix Porschke, Ulrich Kneser, Stefan Studier-Fischer, Paul-Alfred Grützner, Thorsten Guehring

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引用次数: 8

Abstract

Background: The current study investigated the clinical outcome of open elbow dislocations, focusing on the influence of associated soft tissue and bone injury.

Patients and methods: From October 2008 to August 2015, 230 patients with elbow dislocations were treated at the study center. Our retrospective study comprised 21 cases of open elbow dislocations. The mean age of patients was 49 years (20-83 years); there were six (29%) female and 15 (71%) male patients. The range of motion (ROM) of the injured and uninjured elbow was measured, and the Mayo Elbow Performance Score (MEPS), Mayo Wrist Score (MWS), and Disability of Arm, Shoulder and Hand (DASH) score were assessed. Complications and revision surgeries were recorded. The influence of the severity of soft tissue injury (I°/II° open vs. III° open) and type of dislocation (simple vs. complex) was evaluated.

Results: After a 57-month follow-up (range, 24-98 months), the mean DASH score was 20 ± 15, the MEPS was 82 ± 11, and the MWS was 74 ± 22. The ROM of the injured elbow was significantly decreased compared with the uninjured one (arc of ulnohumeral motion: 104° vs. 137°; p = 0.001). Patients with I°/II° open elbow dislocations had a better clinical outcome according to the MEPS (86 ± 11 vs. 76 ± 9; p = 0.045) and a comparable outcome according to the DASH score (19 ± 18 vs. 21 ± 9; p = 0.238). In all, 11 patients (52%) had postoperative complications and 11 patients underwent at least one revision surgery. Complex elbow dislocations had significantly more complications and revision surgeries than simple dislocations (77% vs. 13%; p = 0.008).

Conclusion: Favorable clinical outcomes can be achieved after treatment of open elbow dislocations. These injuries are prone to neurovascular damage and complex dislocations are linked to high rates of complications and revision surgeries.

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开放性肘关节脱位的功能结局和并发症。

背景:本研究调查了开放性肘关节脱位的临床结果，重点关注相关软组织和骨损伤的影响。患者和方法:2008年10月至2015年8月，230例肘关节脱位患者在研究中心接受治疗。我们的回顾性研究包括21例开放性肘关节脱位。患者平均年龄49岁(20 ~ 83岁);女性6例(29%)，男性15例(71%)。测量损伤和未损伤肘关节活动度(ROM)，评估Mayo肘关节功能评分(MEPS)、Mayo手腕评分(MWS)和臂、肩、手残疾(DASH)评分。记录并发症及翻修手术情况。评估软组织损伤严重程度(I°/II°开放vs. III°开放)和脱位类型(单纯性vs.复杂性)的影响。结果:经过57个月(24-98个月)的随访，平均DASH评分为20 ±15,MEPS评分为82 ±11,MWS评分为74 ±22。与未受伤肘关节相比，受伤肘关节活动度明显降低(尺骨运动弧度:104°vs 137°; p = 0.001)。根据MEPS, I°/II°开放性肘关节脱位患者具有更好的临床结果(86 ±11 vs. 76 ±9;p = 0.045)和根据DASH评分的可比结局(19 ±18 vs. 21 ±9; p = 0.238)。总共有11例患者(52%)出现术后并发症，11例患者至少进行了一次翻修手术。复杂肘关节脱位的并发症和翻修手术明显多于单纯脱位(77% vs. 13%; p = 0.008)。结论:开放性肘关节脱位治疗可取得良好的临床效果。这些损伤容易导致神经血管损伤，复杂脱位与并发症和翻修手术的高发生率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand ORTHOPEDICS-

CiteScore

0.80

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期刊介绍： Zielsetzung der Zeitschrift Die Zeitschrift Obere Extremität widmet sich der Versorgung von Verletzungen, Verletzungsfolgen und Erkrankungen im Bereich des Schulter- und des Ellenbogengelenks. Frei eingereichte Originalien präsentieren Forschungsergebnisse aktueller Studien im Bereich der Schulter- und Ellenbogenchirurgie und fördern den wissenschaftlichen Austausch. Vielversprechende Studien, die derzeit durchgeführt werden, sind ebenso willkommen, wie Langzeitstudien, die bewährte Verfahren auf den Prüfstand stellen. Fallberichte beleuchten seltene Indikationen und schildern ungewöhnliche Behandlungsverläufe. Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht gesichertes Wissen mit hoher Relevanz für die tägliche Arbeit in der Schulter- und Ellenbogenchirurgie. Zusätzlich wird in speziellen Rubriken über innovative Behandlungsmaßnahmen, Probleme in der Begutachtung, berufspolitische Entwicklungen und Kongressaktivitäten berichtet. Als gemeinsames Kommunikations- und Weiterbildungsforum für alle Chirurg*innen und Orthopäd*innen mit entsprechender Spezialisierung ist die Zeitschrift Obere Extremität zukunftsorientiert und schließt eine wichtige Lücke im orthopädisch-unfallchirurgischen Informationsangebot. Aims & scope The journal Obere Extremität (Upper Extremity) is dedicated to the treatment of injuries, consequences of injuries and diseases in the area of the shoulder and elbow joint. Freely submitted originals present research results of current studies in the field of shoulder and elbow surgery and promote scientific exchange. Promising studies that are currently being carried out are welcome, as are long-term studies that put proven procedures to the test. Case reports illuminate rare indications and describe unusual courses of treatment. Comprehensive reviews on a current focus topic are the core of each issue. The focus is on secured knowledge with high relevance for the daily work in shoulder and elbow surgery. In addition, special sections report on innovative treatment measures, problems in assessment, professional policy developments and congress activities. As a joint communication and further education forum for all surgeons and orthopaedic surgeons with appropriate specialisation, the journal Obere Extremität is future-oriented and closes an important gap in the orthopaedic trauma surgery information offer. Begutachtung / Peer Review Alle Beiträge, die bei der Zeitschrift Obere Extremität eingereicht werden (einschließlich der eingeladenen Manuskripte) durchlaufen ein Doppelblind-Peer-Review-Verfahren, an dem mindestens zwei unabhängige Experten beteiligt sind.--- All manuscripts submitted to the journal Obere Extremität (including invited manuscripts) undergo a double-blind peer review process involving at least two independent experts. Ethische Richtlinien / Best Practice Guidelines and Publication Ethics Die Zeitschrift Obere Extremität folgt den Richtlinien des Komitees für Publikationsethik (COPE). Autoren wird empfohlen, klinische Studien, die sie zur Veröffentlichung in Betracht ziehen, vor der Veröffentlichung in kostenlosen, öffentlichen Registern für klinische Studien (z.B. www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) zu registrieren. Die Register sind nach den Richtlinien des International Committee of Medical Journal Editors (ICMJE) zu genehmigen. Die Autor*innen sollten am Ende ihres Abstracts den Namen des Studienregisters und ihre Registriernummer für klinische Studien angeben. The journal Obere Extremität (Upper Extremity) follows the Committee of Publications Ethics (COPE) - Guidelines. Authors are recommended to register clinical trials they consider for publication in free, public clinical trial registries (e.g., www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) before publication. The registries are to be approved by the guidelines of the International Committee of Medical Journal Editors (ICMJE). Authors should include the name of the trial register and their clinical trial registration number at the end of their abstract. Deklaration von Helsinki / Declaration of Helsinki Alle zur Veröffentlichung eingereichten Manuskripte, die Ergebnisse von Studien an Proband*innen oder Patient*innen präsentieren, müssen gemäß den Autorenrichtlinien für Originalarbeiten der Deklaration von Helsinki entsprechen. All Manuscripts submitted for publication presenting results from studies on probands or patients must comply with the Declaration of Helsinki according to the author guidelines for original papers.