Journal Article

Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial

Eygendaal, Denise, Iordens, Gijs I T, Van Lieshout, Esther M M, Tuinebreijer, Wim E, De Haan, Jeroen, Verhofstad, Michael H J, Patka, Peter, Schep, Niels W L, Van Beeck, Ed, Den Hartog, Dennis

2017

Overview

Background/aimTo 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.MethodsFrom 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.ResultsQuick-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.ConclusionsEarly 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 numberNTR 2025.

• Publisher: BMJ Publishing Group LTD
• Subject: Adult / Anesthesia / Casts, Surgical / Clinical outcomes / Closed reduction / Early Ambulation - methods / Elbow / Elbow Joint - injuries / Female / Humans / Intervention / Joint Dislocations - diagnostic imaging / Joint Dislocations - etiology / Joint Dislocations - therapy / Male / Musculoskeletal Pain - etiology / Pain / Patients / Physical therapy / Questionnaires / Radiography / Range of Motion, Articular - physiology / Recovery of Function - physiology / Return to Sport - physiology / Treatment Outcome