Overhead arm positioning in the rehabilitation of elbow dislocations: an in vitro biomechanical study

Review written by Dr Val Jones info

Key Points

  1. Early motion post elbow dislocation is essential to prevent complications such as stiffness.
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BACKGROUND & OBJECTIVE

The elbow is the second most commonly dislocated joint in adults, with an incidence of 5-6/100,000 (1). Elbow stiffness is a common complication following dislocation, and early active mobilisation has been found to hasten recovery without increasing the complication rate (2). Overhead exercises have been proposed to improve stability through the effects of gravity to stabilize the elbow (3). The implications of the overhead position with regard to elbow kinematics after combined ligamentous injuries following dislocation have not been previously investigated.

The aim of this study was to determine the influence of the overhead position on elbow stability following combined medial and lateral collateral ligament (MCL and LCL) injuries, which are seen following elbow dislocation.

The elbow is the second most commonly dislocated joint in adults, with an incidence of 5-6/100,000.
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Active elbow motion in the overhead position, simulates normal elbow kinematics even in the presence of combined medial and collateral ligament injuries.

METHODS

In this in vitro biomechanical study, simulated active and passive movements were performed on 11 cadaveric elbows, with the arm in 3 different positions (see Figure 1):

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