In 1999, Rafai, et. al., conducted the research about Pure posterior dislocation of the elbow, a common injury among young individuals, poses a significant challenge in terms of treatment. The main goals of addressing this dislocation are to achieve successful reduction and prevent complications, particularly stiffness and elbow instability. In an unprecedented prospective study, researchers aimed to evaluate two treatment methods, namely plaster immobilization and early mobilization, in terms of their functional and anatomical outcomes.

A total of 50 cases of pure posterior dislocation of the elbow were enrolled in this groundbreaking study, with participants randomly assigned to one of two groups. Group I consisted of 26 cases treated with reduction under general anesthesia, followed by three weeks of plaster immobilization and subsequent rehabilitation. Group II comprised 24 cases treated with reduction under general anesthesia, immediately followed by early mobilization.

The researchers assessed several parameters to gauge the efficacy of the two treatment modalities, including loss of elbow movement amplitude (especially extension), stiffness, instability, relapses, pain, and ossification. Remarkably, the study revealed that early mobilization led to significantly better recovery of elbow function compared to plaster immobilization. In fact, 96% of patients in Group II achieved positive outcomes with the restoration of normal extension, while only 81% of cases in Group I exhibited similar results. Stiffness was notably observed in only 4% of Group II patients, in stark contrast to 19% in Group I, emphasizing the substantial difference between the two approaches. Importantly, no significant disparities were found in terms of pain, relapses, instability, or ossifications between the two treatment groups.

This groundbreaking study presents compelling evidence in favor of early mobilization as a superior treatment option for pure posterior dislocation of the elbow compared to plaster immobilization. Patients who underwent early mobilization experienced significantly better functional recovery without any adverse effects on elbow stability or recurrence rates. These findings herald a paradigm shift in the management of this common injury, highlighting the potential to optimize patient outcomes through a more proactive and tailored approach. By embracing early mobilization, healthcare practitioners can now offer a revolutionary solution that enhances elbow function and mitigates the risk of complications, ultimately leading to improved patient satisfaction and long-term prognosis.

Reference: Rafai, M., Largab, A., Cohen, D., & Trafeh, M. (1999). Pure posterior luxation of the elbow in adults: immobilization or early mobilization. A randomized prospective study of 50 cases. Chirurgie de la main, 18(4), 272-278.