The elbow joint consists of the joining of three bones: one from the upper arm (humerus), and two from the forearm (ulna and radius). The collateral ligaments are strong bands of tissue that hold the bones together in proper alignment. The elbow is both a ball-and-socket joint as well as a hinge joint, allowing the elbow to bend (flexion) and straighten (extension) as well as enable the hand to rotate palm-up (supination) and palm-down (pronation). Both of these motions can be affected by injuries or dislocations.
Elbow dislocations are not very common, but occur when the joint surfaces of the elbow are separated due to an impact on an arm that is partially extended such as in a fall, or in car accidents when the individual reaches forward to cushion the impact of the accident. Dislocations of the elbow are classified as either subluxation, where the joint surfaces are only partially separated, or complete dislocation, where the joint surfaces have completely separated. For either to occur requires that ligaments which hold the bones in place have been injured.
Signs and symptoms of a dislocated elbow include:
- Visible distortion of the elbow joint
- Bruising or pain at the location of the stretched or torn ligaments
- Extreme pain in the elbow, especially after a fall, accident, or injury
It is strongly advised to seek medical attention if an individual experiences severe pain or the joint is obviously distorted.
Diagnosis of a dislocated elbow is generally made upon a physical examination and imaging studies. The physician will examine the injured joint and check the sensation in the arm or hand to determine if there are any signs of a pinched nerve or artery as well as any visible deformity. The physician will also order X-rays to check for fractures in the bones that make up the elbow joint as well as the direction of the dislocation. If possible, the physician will set the dislocated elbow back into place and possibly order an MRI or CT scan to evaluate the condition of the ligaments surrounding the elbow joints.
An elbow dislocation is an emergency situation and the goal of immediate treatment is to return the dislocated elbow into its normal alignment using a reduction maneuver, and can often be done at the hospital’s ER department. Once that is taken care of, the long-term treatment goal is to restore function and reduce any other symptoms. For simple elbow dislocations, the elbow is placed in a splint or sling for two to three weeks and is followed by physical therapy to restore motion and flexibility.
If the elbow dislocation is complex, surgery might be deemed necessary to restore the alignment of the bone and repair any damage to the ligaments. The elbow might need to be protected with an external hinge after surgery to prevent further or repeated dislocation. If the injury involves damage to any nerves or blood vessels, further surgery may be required to repair them. Options must be discussed extensively with the physician to identify the appropriate surgical procedure.
Each patient is unique and their recover will depend on the treatment method prescribed by the physician. If surgery is deemed necessary for the dislocated elbow, recovery will depend on the severity of the condition and the complexity of the procedure. Full recovery from surgery can take several months before an individual may return to their prior level of activity.
CALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY!
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