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Elbow Dislocation

An elbow dislocation occurs when the two bones of the forearm- the radius and ulna- are forcibly moved out of place in relation to the bone of the upper arm- the humerus- and the elbow joint is disrupted.

This is a medical emergency and must be treated by a professional right away due to the risk of damage to other structures such as blood vessels which carry blood to the hand, nerves affecting movement and feeling to the lower arm and hand, ligaments resulting in a chronically unstable joint, and fractures to the bones. If not treated immediately you risk losing the lower arm.

Symptoms

  • Pain
  • Obvious deformity
  • Inability to bend arm
  • Bruising where there is damage to other structures such as ligaments, blood vessels, and nerves.
  • Possible feeling of coldness or loss of feeling in hand if blood vessels or nerves are damaged.

Cause

  • Most common dislocation in children and 2nd most common dislocation in adults after the shoulder
  • Direct trauma to the elbow itself or an extreme force to the hand of an outstretched arm is the most common mechanism of injury/cause.
  • A fall or car accident

Risk factors

  1. Extra laxity in ligaments
  2. Shallow ulnar groove 
  3. Extreme sports or activities that place an individual at increased risk of trauma or falling.
  4. Increased risk of arthritis if the alignment is not good and the elbow does  not move correctly

Prevention

  • Do not do extreme sports or place self at increased risk of injury
  • Avoid situations where there may be increased risk of falling
  • Strengthen muscles around elbow

Diagnosis

Physician exam will then include

  • Check of distal pulse as well as color and warm of hand to assess blood vessel damage
  • Check of feeling and movement in hand to check for nerve damage
  • Check integrity of elbow ligaments
  • X-ray to rule out fracture
  • MRI may be performed if ligament damage suspected

Treatment

  1. Non-surgical:
    • Closed reduction of elbow by a medical profession- putting it back into place by pulling down on the wrist and manipulating the elbow back into normal alignment
    • Pain medication may be necessary as reduction of the dislocation is very painful
    • Splint the elbow in a bent position and place in sling for comfort for 1-3 weeks
    • Physical therapy to restore function and movement
  1. Surgical:
    • An open surgery may be necessary if the physician cannot reduce the dislocation by physical manipulation or if there is damage to other structures in the joint.