Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2010

Open Access 01-12-2010 | Study protocol

Func tional treatment versus plaster for si mple el bow dislocations (FuncSiE): a randomized trial

Authors: Jeroen de Haan, Dennis den Hartog, Wim E Tuinebreijer, Gijs IT Iordens, Roelf S Breederveld, Maarten WGA Bronkhorst, Milko MM Bruijninckx, Mark R De Vries, Boudewijn J Dwars, Denise Eygendaal, Robert Haverlag, Sven AG Meylaerts, Jan-Willem R Mulder, Kees J Ponsen, W Herbert Roerdink, Gert R Roukema, Inger B Schipper, Michel A Schouten, Jan Bernard Sintenie, Senail Sivro, Johan GH Van den Brand, Hub GWM Van der Meulen, Tom PH Van Thiel, Arie B Van Vugt, Egbert JMM Verleisdonk, Jos PAM Vroemen, Marco Waleboer, W Jaap Willems, Suzanne Polinder, Peter Patka, Esther MM van Lieshout, Niels WL Schep

Published in: BMC Musculoskeletal Disorders | Issue 1/2010

Login to get access

Abstract

Background

Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow.

Methods/Design

The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation), health-related quality of life (Short-Form 36 and EuroQol-5D), radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications), costs, and cost-effectiveness.

Discussion

The successful completion of this trial will provide evidence on the effectiveness of a functional treatment for the management of simple elbow dislocations.

Trial Registration

The trial is registered at the Netherlands Trial Register (NTR2025).
Literature
1.
go back to reference Josefsson PO, Nilsson BE: Incidence of elbow dislocation. Acta Orthop Scand. 1986, 57: 537-538. 10.3109/17453678609014788.CrossRefPubMed Josefsson PO, Nilsson BE: Incidence of elbow dislocation. Acta Orthop Scand. 1986, 57: 537-538. 10.3109/17453678609014788.CrossRefPubMed
2.
go back to reference Hildebrand KA, Patterson SD, King GJ: Acute elbow dislocations: simple and complex. Orthop Clin North Am. 1999, 30: 63-79. 10.1016/S0030-5898(05)70061-4.CrossRefPubMed Hildebrand KA, Patterson SD, King GJ: Acute elbow dislocations: simple and complex. Orthop Clin North Am. 1999, 30: 63-79. 10.1016/S0030-5898(05)70061-4.CrossRefPubMed
3.
go back to reference Conn J, Wade PA: Injuries of the elbow: a ten year review. J Trauma. 1961, 1: 248-268. 10.1097/00005373-196105000-00004.CrossRef Conn J, Wade PA: Injuries of the elbow: a ten year review. J Trauma. 1961, 1: 248-268. 10.1097/00005373-196105000-00004.CrossRef
4.
go back to reference Josefsson PO, Johnell O, Gentz CF: Long-term sequelae of simple dislocation of the elbow. J Bone Joint Surg Am. 1984, 66: 927-930.PubMed Josefsson PO, Johnell O, Gentz CF: Long-term sequelae of simple dislocation of the elbow. J Bone Joint Surg Am. 1984, 66: 927-930.PubMed
5.
go back to reference Josefsson PO, Gentz CF, Johnell O, Wendeberg B: Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. A prospective randomized study. J Bone Joint Surg Am. 1987, 69: 605-608.PubMed Josefsson PO, Gentz CF, Johnell O, Wendeberg B: Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. A prospective randomized study. J Bone Joint Surg Am. 1987, 69: 605-608.PubMed
6.
go back to reference Rafai M, Largab A, Cohen D, Trafeh M: [Pure posterior luxation of the elbow in adults: immobilization or early mobilization. A randomized prospective study of 50 cases]. Chir Main. 1999, 18: 272-278.PubMed Rafai M, Largab A, Cohen D, Trafeh M: [Pure posterior luxation of the elbow in adults: immobilization or early mobilization. A randomized prospective study of 50 cases]. Chir Main. 1999, 18: 272-278.PubMed
7.
go back to reference Maripuri SN, Debnath UK, Rao P, Mohanty K: Simple elbow dislocation among adults: a comparative study of two different methods of treatment. Injury. 2007, 38: 1254-1258. 10.1016/j.injury.2007.02.040.CrossRefPubMed Maripuri SN, Debnath UK, Rao P, Mohanty K: Simple elbow dislocation among adults: a comparative study of two different methods of treatment. Injury. 2007, 38: 1254-1258. 10.1016/j.injury.2007.02.040.CrossRefPubMed
8.
go back to reference Royle SG: Posterior dislocation of the elbow. Clin Orthop Relat Res. 1991, 201-204. Royle SG: Posterior dislocation of the elbow. Clin Orthop Relat Res. 1991, 201-204.
9.
go back to reference Mehlhoff TL, Noble PC, Bennett JB, Tullos HS: Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg Am. 1988, 70: 244-249.PubMed Mehlhoff TL, Noble PC, Bennett JB, Tullos HS: Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg Am. 1988, 70: 244-249.PubMed
10.
go back to reference Protzman RR: Dislocation of the elbow joint. J Bone Joint Surg Am. 1978, 60: 539-541.PubMed Protzman RR: Dislocation of the elbow joint. J Bone Joint Surg Am. 1978, 60: 539-541.PubMed
11.
go back to reference Schippinger G, Seibert FJ, Steinbock J, Kucharczyk M: Management of simple elbow dislocations. Does the period of immobilization affect the eventual results?. Langenbecks Arch Surg. 1999, 384: 294-297. 10.1007/s004230050206.CrossRefPubMed Schippinger G, Seibert FJ, Steinbock J, Kucharczyk M: Management of simple elbow dislocations. Does the period of immobilization affect the eventual results?. Langenbecks Arch Surg. 1999, 384: 294-297. 10.1007/s004230050206.CrossRefPubMed
12.
go back to reference Riel KA, Bernett P: [Simple elbow dislocation. Comparison of long-term results after immobilization and functional treatment]. Unfallchirurg. 1993, 96: 529-533.PubMed Riel KA, Bernett P: [Simple elbow dislocation. Comparison of long-term results after immobilization and functional treatment]. Unfallchirurg. 1993, 96: 529-533.PubMed
13.
go back to reference de Haan J, Schep NW, Tuinebreijer WE, Patka P, den Hartog D: Simple elbow dislocations: a systematic review of the literature. Arch Orthop Trauma Surg. 2010, 130: 241-249. 10.1007/s00402-009-0866-0.CrossRefPubMed de Haan J, Schep NW, Tuinebreijer WE, Patka P, den Hartog D: Simple elbow dislocations: a systematic review of the literature. Arch Orthop Trauma Surg. 2010, 130: 241-249. 10.1007/s00402-009-0866-0.CrossRefPubMed
14.
go back to reference de Haan J, Schep NWL, Peters RW, Tuinebreijer WE, den Hartog D: [Simple elbow dislocations in the Netherlands: what are Dutch surgeons doing?]. Nederlands Tijdschrift voor Traumtologie. 2009, 17: 124-127. 10.1007/BF03081720.CrossRef de Haan J, Schep NWL, Peters RW, Tuinebreijer WE, den Hartog D: [Simple elbow dislocations in the Netherlands: what are Dutch surgeons doing?]. Nederlands Tijdschrift voor Traumtologie. 2009, 17: 124-127. 10.1007/BF03081720.CrossRef
15.
go back to reference Hudak PL, Amadio PC, Bombardier C: Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996, 29: 602-608. 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L.CrossRefPubMed Hudak PL, Amadio PC, Bombardier C: Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996, 29: 602-608. 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L.CrossRefPubMed
16.
go back to reference Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C: Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001, 14: 128-146.CrossRefPubMed Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C: Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001, 14: 128-146.CrossRefPubMed
17.
go back to reference Morrey BF, An KN, Chao EYS: Functional evaluation of the elbow. The Elbow and Its Disorders. Edited by: Morrey BF. 1993, Philadelphia: WB Saunders, 86-89. 2 Morrey BF, An KN, Chao EYS: Functional evaluation of the elbow. The Elbow and Its Disorders. Edited by: Morrey BF. 1993, Philadelphia: WB Saunders, 86-89. 2
18.
go back to reference Dawson J, Doll H, Boller I, Fitzpatrick R, Little C, Rees J, Jenkinson C, Carr AJ: The development and validation of a patient-reported questionnaire to assess outcomes of elbow surgery. J Bone Joint Surg Br. 2008, 90: 466-473. 10.1302/0301-620X.90B4.20290.CrossRefPubMed Dawson J, Doll H, Boller I, Fitzpatrick R, Little C, Rees J, Jenkinson C, Carr AJ: The development and validation of a patient-reported questionnaire to assess outcomes of elbow surgery. J Bone Joint Surg Br. 2008, 90: 466-473. 10.1302/0301-620X.90B4.20290.CrossRefPubMed
19.
go back to reference Floor S, Overbeke AJ: [Questionnaires on the quality of life in other than the Dutch language used in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine): the translation procedure and arguments for the choice of the questionnaire]. Ned Tijdschr Geneeskd. 2006, 150: 1724-1727.PubMed Floor S, Overbeke AJ: [Questionnaires on the quality of life in other than the Dutch language used in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine): the translation procedure and arguments for the choice of the questionnaire]. Ned Tijdschr Geneeskd. 2006, 150: 1724-1727.PubMed
20.
go back to reference Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
21.
go back to reference Brooks R, Rabin R, de Charro F, Eds: The measurement and valuation of health status using EQ-5D: a European perspective. 2003, Dordrecht: Kluwer Academic Publishers Brooks R, Rabin R, de Charro F, Eds: The measurement and valuation of health status using EQ-5D: a European perspective. 2003, Dordrecht: Kluwer Academic Publishers
22.
go back to reference Lamers LM, Stalmeier PF, McDonnell J, Krabbe PF, van Busschbach JJ: [Measuring the quality of life in economic evaluations: the Dutch EQ-5D tariff]. Ned Tijdschr Geneeskd. 2005, 149: 1574-1578.PubMed Lamers LM, Stalmeier PF, McDonnell J, Krabbe PF, van Busschbach JJ: [Measuring the quality of life in economic evaluations: the Dutch EQ-5D tariff]. Ned Tijdschr Geneeskd. 2005, 149: 1574-1578.PubMed
23.
go back to reference Broberg MA, Morrey BF: Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res. 1987, 109-119. Broberg MA, Morrey BF: Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res. 1987, 109-119.
Metadata
Title
Func tional treatment versus plaster for si mple el bow dislocations (FuncSiE): a randomized trial
Authors
Jeroen de Haan
Dennis den Hartog
Wim E Tuinebreijer
Gijs IT Iordens
Roelf S Breederveld
Maarten WGA Bronkhorst
Milko MM Bruijninckx
Mark R De Vries
Boudewijn J Dwars
Denise Eygendaal
Robert Haverlag
Sven AG Meylaerts
Jan-Willem R Mulder
Kees J Ponsen
W Herbert Roerdink
Gert R Roukema
Inger B Schipper
Michel A Schouten
Jan Bernard Sintenie
Senail Sivro
Johan GH Van den Brand
Hub GWM Van der Meulen
Tom PH Van Thiel
Arie B Van Vugt
Egbert JMM Verleisdonk
Jos PAM Vroemen
Marco Waleboer
W Jaap Willems
Suzanne Polinder
Peter Patka
Esther MM van Lieshout
Niels WL Schep
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2010
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-11-263

Other articles of this Issue 1/2010

BMC Musculoskeletal Disorders 1/2010 Go to the issue