Elbow Dislocation

Elbow dislocations are the second most common dislocation of the upper extremity.  Approximatelfy 90% of elbow dislocations are posterior or posterlateral dislocations.  The annual incidence  of elbow dislocations is around 6 / 100,000 persons.  The majority of dislcations result from falls on an outstretched arms. The most common long term residual effect is loss of terminal extension.  Nearly half of elbow dislocations occur in sports.  Elbow dislocation most commonly occurs in adolescent males.  The sports in which elbow dislocations most commonly occur are football in males and gymnastics and skating in females.  

The primary constraints to elbow instability are the ulnohumeral articulation, medial collateral ligament(MCL), lateral collateral ligament(LCL).  The secondary constraints are radial head, common flexor and extensor origins, capsule. Any of these can be injured in an elbow dislocation.  The elbow also has dynamic constaints which are the muscles which cross the elbow, mainly the triceps, anconeus and brachialis.

People who sustain an elbow dislocation typically have an obvious deformity in the elbow after a fall onto the outstretched hand.  They will have signifant pain and swelling in the elbow.  Anyone suspected of having an elbow dislocation should be seen by an orthopaedic surgeon as soon as possible. 

Xrays are needed to ensure that an elbow fracture is not the main injury, or an associated injury.  Treatment is initially centered around reducing the dislocation.  If a simple elbow dislocation is the only injury, patient are generally splinted or placed into a sling for 3-7 days.  It is important that they follow up with their orthopaedic surgeon for continued care which is generally early range of motion exercises and physical therapy.  Elbow dislocations are frequently associated with other injuries which may change the treatment course.

The most common complication after an elbow dislocation is elbow stiffness or a flexion contracture.  When the acute pain has subsided in 5 to 7 days,  patients must begin early active motion exercises.  People with elbow dislocations frequently have some minor loss of motion for the long term.   Other complications of elbow dislocations include:  Heterotopic ossification, Nerve injuries, Redislocation or recurrent instability.  Overall around 60% of patients who sustain an elbow dislocation will have residual symptoms, mainly loss of extension.

Futher information about Elbow Dislocation can be found at the following sites:

Please read this information carefully. Write down any questions that you have about your diagnosis and its treatment and discuss them with your surgeon. Working together you and your surgeon will determine the best treatment for you.

 

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