Josefsson simple dislocation RCT

Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. A prospective randomized study.

Josefsson PO, Gentz CF, Johnell O, et al. The Journal of bone and joint surgery. American volume 1987 · PMID 3571318 · doi:10.2106/00004623-198769040-00018

Question

After a simple elbow dislocation, does surgical repair of the torn ligaments improve outcome over non-operative care?

Design

Small prospective randomised trial in Sweden.

Patients

Adults with simple (no fracture) elbow dislocations.

Intervention

Surgical repair of torn collateral ligaments

Comparison

Closed reduction and plaster immobilisation

Primary outcome

Range of motion, stability and symptoms at follow-up

Key result

Surgical repair gave no advantage over non-operative treatment.

Limitations

Very small sample and older immobilisation protocol.

Impact on practice

Simple elbow dislocations that are stable after reduction are managed non-operatively with early mobilisation.