• Elbow Dislocation

    Definition

    The elbow includes three bones, the humerus of the upper arm and the radius and ulna of the lower arm. The bottom portion of the upper arm bone sits in a groove in the ulna. The end of the radius lies against the end of the upper arm bone and allows the forearm to rotate. A series of ligaments connects the bones and keeps them in place during movement.
    An elbow dislocation occurs when the bones are pulled out of place. It often involves damage to the ligaments and sometimes damage to the bones. A dislocation will make certain movements impossible.
    The Elbow Joint
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Elbow dislocation is caused by a sudden traumatic force on the elbow, such as a fall on an outstretched arm.

    Risk Factors

    Factors that may increase your risk of getting an elbow fracture dislocation include:
    • Instability in the structure of your elbow joint
    • Previous injury or surgery to your elbow joint
    • Playing sports

    Symptoms

    Elbow dislocation may cause:
    • Severe pain at the elbow with or without swelling
    • Pain with movement
    • Difficulty bending arm or moving forearm
    • Bruising
    • Abnormal appearance of the elbow

    Diagnosis

    Your doctor will ask about your symptoms, medical history, and what you were doing when your elbow was injured. Your elbow will be thoroughly examined to check for swelling and tenderness. Your doctor will may be able to make the diagnosis based on your symptoms.
    An x-ray may be taken to look for evidence of the dislocation or fractures.
    Other imaging tests may be done to see if there is any damage to nerves, blood vessels or ligaments:
    Elbow dislocations are graded according to their severity:
    • Simple dislocation—No major bone injury.
    • Complex dislocation—Fractures of the bone and damage to surrounding tissue such as ligaments, nerves, and blood vessels are likely.

    Treatment

    The doctor can manipulate most elbows back into place. Medications to relieve pain and help you relax will be given before the elbow is moved. Once the elbow is repaired, medication will be given to help reduce swelling and pain.
    Other aspects of your treatment depend on the severity of the dislocation and other tissue damage.

    Immobilization

    The elbow joint will be immobilized with a splint or sling to help it heal properly. You may need to wear the support for up to three weeks, even if it was a simple dislocation.

    Physical Therapy

    Exercises and rehabilitation are an important part of recovery. Motion exercises are started as soon as possible to help prevent stiffness and permanent loss of motion.
    Physical therapy can help restore strength, range of motion, and flexibility.

    Surgery

    Complex dislocations may require surgery to:
    • Restore proper alignment
    • Repair damaged bones ligaments, blood vessels, or nerves
    An external hinge may be needed to support the bones while they heal. Future surgeries may also be needed to improve motion and remove scar tissue.

    Prevention

    To help reduce your chance of getting an elbow dislocation, take these steps:
    • Don’t put your arm out when you fall. If you can, turn your body, fall on your side, and roll.
    • Wear protective equipment and use proper technique when playing sports.
    • Keep your arm muscles strong with regular exercise.

    RESOURCES

    American Academy of Family Physicians http://familydoctor.org

    American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Association of General Surgeons http://www.cags-accg.ca

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Elbow dislocation. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00029. Updated October 2007. Accessed December 9, 2013.

    Elbow dislocation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 16, 2013. Accessed December 9, 2013.

    Englert C, Zellner J, et al. Elbow Dislocations: A Review Ranging from Soft Tissue Injuries to Complex Elbow Fracture Dislocations. Adv Orthop. 2013. [Epub ahead of print].

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