Residual subluxation of the elbow after dislocation or fracture-dislocation: treatment with active elbow exercises and avoidance of varus stress

Abstract

During a 6-year period, 2 surgeons prescribed active elbow exercises and avoidance of shoulder abduction (varus stress) for 23 patients (15 men, 8 women) with a mean age of 43 years (range, 19-74 years) who had slight residual subluxation of a dislocated elbow after either nonoperative (3 simple dislocations and 2 fracture-dislocations) or operative treatment (18 fracture-dislocations). A stable elbow was achieved in all 23 patients, although 1 patient, treated late, had a very slight residual posterior subluxation of the radial head on radiographs. After a mean of 24 months (range, 12-45 months), the average flexion arc was 113 degrees , with mean flexion of 132 degrees and mean flexion contracture of 20 degrees . The mean Broberg-Morrey score was 90 points (range, 61-100 points). Ratings were excellent in 9 patients, good in 10, and fair in 4. Mild radiographic signs of arthrosis (type 1 Broberg-Morrey) were present in 2 patients. Slight postreduction subluxation of the elbow, without detrimental contact of the articular surfaces, a type of pseudosubluxation of the elbow sometimes referred to as the "drop sign," can be treated with active exercises and avoidance of varus stress.