Return to Sport Following Elbow Dislocation: A Systematic Review.

Background: Elbow dislocation is the second most common large joint dislocation in athletes, frequently occurring in contact and high-impact sports such as football, wrestling, and gymnastics. While these injuries typically result from a fall onto an outstretched hand with the elbow in near full extension, both nonoperative and surgical treatments have demonstrated high success rates in restoring elbow function, enabling athletes to return to sport (RTS) with favorable functional outcomes. Purpose/Hypothesis: The purpose of this systematic review was to evaluate RTS rate, time to return, and functional outcomes in athletes following elbow dislocation. It was hypothesized that most athletes would successfully return to their sport regardless of treatment modality and that nonoperative treatment would be associated with a shorter recovery timeline compared with surgical intervention. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Embase, Cochrane, and Web of Science were searched through March 20, 2025, for studies that investigated the management of elbow dislocation in athletes. Data were extracted on mechanism of injury, dislocation treatment, complications, follow-up duration, and outcome parameters, including RTS, return to the same level of play, time to return, and elbow outcome scores. Results: A total of 9 studies covering 970 athletes met the inclusion criteria for analysis. Across the studies that reported sex and age, 328 of 417 (78.7%) of the athletes were male, with a weighted mean age of 29.6 years. The mean follow-up was 72 months across the 5 studies that provided follow-up data. Across 8 of the 9 studies, 97 of 417 athletes with elbow dislocations (23.3%) underwent surgical treatment, while 320 received nonoperative management. Across 5 studies of 161 dislocations, only 18 cases (11.2%) resulted in complications. Return to any sporting activity, reported for 274 athletes across 7 studies, was observed in 99.3% of patients (n = 272/274) after a mean of 11.4 ± 7.7 weeks. On average, athletes treated nonoperatively returned sooner (8.95 weeks) than surgically treated athletes (16.3 weeks). Mayo Elbow Performance Score, Elbow Self-Assessment Score, and subjective elbow value scores demonstrated excellent elbow performance after injury. Conclusion: The results supported the hypothesis that athletes with elbow dislocation demonstrated excellent functional outcomes and high RTS rates, with most returning within 10 weeks. Most returned regardless of treatment, with nonoperative management generally associated with a shorter return timeline than surgical intervention.