AIM: To evaluate the management, clinical outcome and cost implications of three different treatment regimes for simple elbow dislocations.METHODS: Following institutional board approval, we performed a retrospective ...AIM: To evaluate the management, clinical outcome and cost implications of three different treatment regimes for simple elbow dislocations.METHODS: Following institutional board approval, we performed a retrospective review of all consecutive patients treated for simple elbow dislocations in a Level Ⅰ trauma centre between January 2008 and December 2010. Based on the length of elbow immobilisation(LOI), patients were divided in three groups(Group I, < 2 wk; Group Ⅱ, 2-3 wk; and Group Ⅲ, > 3 wk). Outcome was considered satisfactory when a patient could achieve a pain-free range of motion ≥ 100°(from 30° to 130°). The associated direct medical costs for the treatment of each patient were then calculated and analysed.RESULTS: We identified 80 patients who met the inclusion criteria. Due to loss to follow up, 13 patients were excluded from further analysis, leaving 67 patients for the final analysis. The mean LOI was 14 d(median 15 d; range 3-43 d) with a mean duration of hospital engagement of 67 d(median 57 d; range 10-351 d). Group Ⅲ(prolonged immobilisation) had a statistically significant worse outcome in comparison to Group Ⅰ?and Ⅱ(P = 0.04 and P = 0.01 respectively); however, there was no significant difference in the outcome between groups Ⅰ?and Ⅱ(P = 0.30). No statistically significantdifference in the direct medical costs between the groups was identified.CONCLUSION: The length of elbow immobilization doesn't influence the medical cost; however immobilisation longer than three weeks is associated with persistent stiffness and a less satisfactory clinical outcome.展开更多
文摘AIM: To evaluate the management, clinical outcome and cost implications of three different treatment regimes for simple elbow dislocations.METHODS: Following institutional board approval, we performed a retrospective review of all consecutive patients treated for simple elbow dislocations in a Level Ⅰ trauma centre between January 2008 and December 2010. Based on the length of elbow immobilisation(LOI), patients were divided in three groups(Group I, < 2 wk; Group Ⅱ, 2-3 wk; and Group Ⅲ, > 3 wk). Outcome was considered satisfactory when a patient could achieve a pain-free range of motion ≥ 100°(from 30° to 130°). The associated direct medical costs for the treatment of each patient were then calculated and analysed.RESULTS: We identified 80 patients who met the inclusion criteria. Due to loss to follow up, 13 patients were excluded from further analysis, leaving 67 patients for the final analysis. The mean LOI was 14 d(median 15 d; range 3-43 d) with a mean duration of hospital engagement of 67 d(median 57 d; range 10-351 d). Group Ⅲ(prolonged immobilisation) had a statistically significant worse outcome in comparison to Group Ⅰ?and Ⅱ(P = 0.04 and P = 0.01 respectively); however, there was no significant difference in the outcome between groups Ⅰ?and Ⅱ(P = 0.30). No statistically significantdifference in the direct medical costs between the groups was identified.CONCLUSION: The length of elbow immobilization doesn't influence the medical cost; however immobilisation longer than three weeks is associated with persistent stiffness and a less satisfactory clinical outcome.
