Assessment of Elbow Trauma and Antibiotic Prophylaxis of Prosthetic Elbow Replacement

There has been an increasing interest in using Patient-reported outcomes (PROMs) and they are becoming a key tool in research, decision-making and clinical care. The Oxford Elbow Score (OES) is the only elbow-specific rating system for which measurement properties have been assessed with high-quality methodology. There is a lack of well-validated PROMs in Swedish for elbow conditions and for elbow trauma (paper I).

The interpretation of differences in scores of PROMs between groups is aided by the Minimal Important Difference (MID) and Smallest Detectable Change (SDC). MID can be defined as the smallest measured change in a score that the patient perceives as important. MIDs have not been estimated for the OES in a trauma population (paper II).

Proximal radius fracture is a common fracture in the elbow and can cause disturbances in elbow movement, stability, and loss of rotational ability in the forearm. There are several studies that have shown that associated injuries are common. Little has been written to describe the relationship of radial head fractures to associated ligament injuries in the elbow (paper III).

In severe trauma to the elbow, arthroplasty is becoming increasingly frequent, though it is a relatively rare procedure. Periprosthetic Joint Infection (PJI) in elbow arthroplasty is a serious complication, with great suffering for the patients and large costs for the healthcare. There is a lack of evidence as to the best antibiotic prophylaxis in elbow arthroplasty (paper IV).

The primary purpose of this thesis is to increase understanding of elbow trauma, improve assessment systems, improve antibiotic prophylaxis for elbow replacement, and thereby improve the care of patients suffering fractures and ligament injuries of the elbow.