Dr. Carlos Rebollón
Schedule an Appointment
Elbow dislocation, also known as dislocated elbow, is the most common type of joint injury in children. It is also the second most prone joint to dislocation in adulthood, especially when a fall occurs with an outstretched hand.
Elbow dislocation occurs when the bones that make up the joint (humerus, ulna, and radius) lose their alignment. It is considered a complete dislocation when the bones lose direct contact with each other, while a partial or subluxation dislocation occurs when some of the bones maintain slight alignment.
For a complete elbow dislocation to occur, the trauma must be forceful and significant. In some cases, elbow dislocations can lead to other associated complications such as fractures, nerve injuries (ulnar or median nerve), arterial injuries (brachial artery), among others.
POSTERIOR ELBOW DISLOCATION
The majority of elbow dislocations (around 90%) fall into this type. The main causes are falls on the arm with the elbow extended and the forearm supinated, as well as car accidents.
Posterior elbow dislocation is one of the most common elbow injuries in sports such as cycling and skating.
SYMPTOMS OF ELBOW DISLOCATION
The symptoms accompanying a complete elbow dislocation include:
On the other hand, the signs of a partial or subluxation elbow dislocation are as follows:
ANTERIOR ELBOW DISLOCATION
It is a rare injury that occurs due to a fall or blow on the flexed tip of the elbow. Anterior elbow dislocation can result in anterior displacement of the ulna and radius, displacement of bones in front of the muscles, extensive ligament tears, or triceps avulsion.
ELBOW DISLOCATION TREATMENT
Elbow dislocations require immediate medical attention following the injury (or at least within the first 30 minutes). Traction and countertraction techniques are typically used to reduce the dislocation.
The maneuvers to relocate the dislocated bone are painful and should be performed exclusively by a professional. The doctor is responsible for administering sedatives and analgesics to the dislocated patient to reduce the sensation of pain throughout the procedure.
Once all reduction maneuvers have been performed, the anteroposterior and mediolateral stability of the joint should be checked through a physical examination. Subsequently, radiographic studies are conducted in the elbow area to rule out additional internal complications.
After reduction is completed, the joint area is immobilized with a splint for a maximum of five to seven days. During this time, both pain and swelling should have significantly decreased.
The next step in the patient’s recovery plan is to start a specialized exercise routine to gradually regain joint mobility and prevent stiffness. These controlled exercises are alternated with arm immobilization using a sling for an additional couple of weeks.
It should be noted that athletes or individuals with symptoms of dislocated bones or torn ligaments may require surgical treatment to repair them and prevent the recurrence of dislocations.
If we count the first week with the splint after the dislocation, plus the two or three weeks following the reduction, and add 4 weeks of controlled flexion and extension exercises, we can estimate that the patient’s temporary disability can last a total of 10 to 12 weeks.
If the dislocation was chronic and required surgeries for ligament reconstruction or other types of surgical procedures, this time can be extended by several more months.
It is very likely that your specialist will recommend keeping a follow-up of the case for a while, as complete elbow dislocations can lead to future instabilities that should not go unnoticed.
RISKS OF INADEQUATELY TREATING AN ELBOW DISLOCATION
Elbow dislocation is considered an emergency injury, which means that the patient must quickly seek medical care after the traumatic event. But why is this so important? Complex elbow dislocations affect a significant portion of the elbow structures, which can range from fractures in any of its bones to the injury of nerves or blood vessels that pass through the elbow, resulting in severe complications if not treated promptly.
ELBOW DISLOCATION SEQUELAE
If a simple elbow dislocation is promptly and effectively treated, it usually does not lead to other complications. However, when the dislocation is not treated in a timely manner or the medical recommendations and treatment plan are not fully followed, the patient may experience sequelae such as:
Caused by prolonged immobilization.
Experiencing frequent dislocations again.
Caused by stretching of tendons and connective tissues.
Frequently Asked Questions
In most cases, elbow dislocations go through a period of immobilization with a splint for 2 or 3 weeks. Subsequently, controlled movements of flexion and extension of the elbow, alternating with an orthopedic elbow brace, are initiated for an additional 4 weeks. This leaves us with an estimated recovery time of 10 to 12 weeks, depending on the patient’s progress.
Dislocations can be simple or complex depending on the severity of the trauma that caused them. In this regard, simple dislocations can be quickly recovered with conservative treatments. However, complex dislocations present a completely different scenario, as they can involve bones, nerves, or blood vessels, causing many more difficulties.
The most recommended position for sleeping with an elbow dislocation is lying on your back. For this, you should place a pillow next to your body to support the affected arm. Some people also choose to sleep in a reclining chair so that the arm remains in a neutral position, making rest more comfortable.
Surgical procedures are usually reserved for patients with complex dislocations that involve bone fractures, nerve damage, injuries to blood vessels, ruptures or tears to other tissues, etc. Surgery is also performed on patients with chronic dislocations (dislocations that were not medically treated during the first weeks), where the elbow has undergone internal changes such as joint fibrosis and heterotopic calcifications that prevent closed reduction maneuvers.