[Simple elbow dislocations in children : Systematic review and meta-analysis].

Abstract

BACKGROUND\nSimple elbow dislocations in childhood are rare. Nevertheless, they have a high relevance because they can result in subsequent damage and limitations in range of motion. The treatment options are controversially discussed.\n\n\nAIM\nThe purpose of the study was to review the literature and to derive a\xa0recommendation for the best treatment concept.\n\n\nMATERIAL AND METHODS\nA\xa0systematic literature search was performed via Ovid Medline, whereby 1645 publications were identified (initially nonspecific for age) and evaluated in a stepwise approach. Of these publications four met the inclusion criteria of the authors. The analysis was carried out descriptively and in a\xa0meta-analysis.\n\n\nRESULTS\nThe 4\xa0publications included described simple elbow dislocations in 81\xa0children (≤16\xa0years). The weighted average age was 9.9\xa0years with a\xa0gender ratio of 3.8 (boys:girls). The median follow-up was 49\xa0months. Posterior and posterolateral dislocations were the most common with 73%. In 69\xa0children the treatment was conservative and of these 66 were immobilized for longer than 2\xa0weeks after closed reduction. The 12\xa0children who had surgical treatment suffered dislocations that had not been reduced for longer than 3\xa0weeks. The success rate of the conservatively treated immobilized group was 88%, of the conservatively treated non-immobilized group 70% and of the surgical group 42%. The differences between the success rates of the treatment methods was significant (p\u202f=\u20090.032).\n\n\nCONCLUSION\nSimple elbow dislocations in children are rare. They most commonly occur in posterior and posterolateral directions. The prognosis is favorable; however a\xa0timely diagnosis and correct reduction are relevant for a\xa0good outcome.