Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial. Issue 6 (14th July 2015)

• Record Type: Journal Article
• Authors: Iordens, Gijs I T; Van Lieshout, Esther M M; Schep, Niels W L; De Haan, Jeroen; Tuinebreijer, Wim E; Eygendaal, Denise; Van Beeck, Ed; Patka, Peter; Verhofstad, Michael H J; Den Hartog, Dennis
• Other Names: author non-byline.; Breederveld Roelf S author non-byline.; Bronkhorst Maarten WGA author non-byline.; De Vries Mark R author non-byline.; Dwars Boudewijn J author non-byline.; Haverlag Robert author non-byline.; Meylaerts Sven AG author non-byline.; Mulder Jan-Willem R author non-byline.; Ponsen Kees J author non-byline.; Roerdink W Herbert author non-byline.; Roukema Gert R author non-byline.; Schipper Inger B author non-byline.; Schouten Michel A author non-byline.; Sintenie Jan Bernard author non-byline.; Sivro Senail author non-byline.; Van den Brand Johan GH author non-byline.; Van der Linden Frits M author non-byline.; Van der Meulen Hub GWM author non-byline.; Verleisdonk Egbert JMM author non-byline.; Vroemen Jos PAM author non-byline.; Waleboer Marco author non-byline.; Willems W Jaap author non-byline.
• Is Part Of: British journal of sports medicine. Volume 51:Issue 6(2017)
• Page Start: 531
• Page End: 538
• Publication Date: 2015-07-14
• Subjects: Elbow; Sports medicine -- Periodicals; 617.1027
• DOI: 10.1136/bjsports-2015-094704
• Languages: English
• ISSNs: 0306-3674

Abstract

Abstract : Background/aim: To compare outcome of early mobilisation and plaster immobilisation in patients with a simple elbow dislocation. We hypothesised that early mobilisation would result in earlier functional recovery. Methods: From August 2009 to September 2012, 100 adult patients with a simple elbow dislocation were enrolled in this multicentre randomised controlled trial. Patients were randomised to early mobilisation (n=48) or 3 weeks plaster immobilisation (n=52). Primary outcome measure was the Quick Disabilities of the Arm, Shoulder, and Hand ( Quick -DASH) score. Secondary outcomes were the Oxford Elbow Score, Mayo Elbow Performance Index, pain, range of motion, complications and activity resumption. Patients were followed for 1 year. Results: Quick -DASH scores at 1 year were 4.0 (95% CI 0.9 to 7.1) points in the early mobilisation group versus 4.2 (95% CI 1.2 to 7.2) in the plaster immobilisation group. At 6 weeks, early mobilised patients reported less disability ( Quick -DASH 12 (95% CI 9 to 15) points vs 19 (95% CI 16 to 22); p<0.05) and had a larger arc of flexion and extension (121° (95% CI 115° to 127°) vs 102° (95% CI 96° to 108°); p<0.05). Patients returned to work sooner after early mobilisation (10 vs 18 days; p=0.020). Complications occurred in 12 patients; this was unrelated to treatment. No recurrent dislocations occurred. Conclusions: Early active mobilisation is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier without increasing the complication rate. No evidence was found supporting treatment benefit at 1 year. Trial registration number: NTR 2025.