Elbow Dislocation

An elbow dislocation is a serious injury usually caused by a direct fall onto the hand with the elbow in extension and flexion. As a result, the bones of the forearm (radius and ulna) move away from their normal position and articulation with the humerus. The mechanism of injury may be a fall from a height, injuries during sports and other high-energy trauma. Patients with a dislocation often also sustain fractures in the elbow area.

An elbow dislocation is an emergency injury that requires immediate treatment by a specialized orthopaedic surgeon.

ELBOW DISLOCATION – SYMPTOMS

The main symptoms include:

• Pain: Severe pain in the elbow and forearm area

• Swelling: Swelling around the area of injury.

• Limited mobility: Inability to move the elbow

• Bruising: Bruising and discoloration of the skin around the site of the dislocation.

• Deformity: Change in the shape of the elbow joint.

ELBOW DISLOCATION – DIAGNOSIS

If you think you have sustained an elbow dislocation, seek medical attention immediately. The orthopaedic surgeon will examine the area and request X-rays to confirm the dislocation and identify any associated fractures. After the dislocation has been reduced, in some cases further investigation with a CT scan with three-dimensional reconstruction or an MRI scan may be required. These investigations are performed to further assess bone and ligament injuries and to determine whether the dislocation should be treated conservatively or surgically.

ELBOW DISLOCATION – CONSERVATIVE TREATMENT

The first priority in an elbow dislocation is its immediate reduction. Using special maneuvers, the orthopaedic surgeon restores the elbow joint to its normal position, followed by a detailed assessment of the vascular and neurological status of the limb. If the elbow is stable after reduction and there are no associated fractures, the dislocation is treated conservatively as follows:

1. Immobilization: Immobilization using a sling for 2–3 weeks. The use of a plaster splint is not recommended.

2. Pain relief: Use of non-steroidal anti-inflammatory drugs to manage pain and reduce inflammation.

3. Ice therapy: Ice therapy is recommended for 15–20 minutes, four times a day.

4. Home exercise program: From the first day of the dislocation, an individualized home exercise program is started to prevent stiffness.

5. Physiotherapy: Physiotherapy begins 3 weeks after the dislocation and includes gradual exercises to restore range of motion and strengthen the shoulder.

It is very important that, as soon as a fracture is diagnosed, the patient removes jewellery such as rings or a wedding ring from the fingers of the hand. The hematoma from the dislocation will spread towards the elbow and the fingers, which will become swollen, and any jewellery may reduce blood flow. It is important to inform the patient from the outset that, over the following weeks, the swelling and bruising will spread towards the fingers.

ELBOW DISLOCATION – SURGICAL TREATMENT

Surgical treatment is recommended for unstable dislocations or when fractures of the elbow bones are also present and varies depending on the extent and severity of the injuries.

If you have sustained an elbow dislocation, visit the specialized orthopaedic surgeon Mr Andreas Leonidou.