Dr. Carlos Rebollón

Elbow dislocation
in Panama

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Elbow dislocation

Elbow dislocation

Elbow dislocation, also known as dislocated elbow, is the most common type of joint injury in children and the second most prone to dislocate in adulthood, especially when experiencing a fall with the arm extended.

Dislocation occurs when the bones that make up the elbow joint (humerus, ulna, and radius) lose their alignment. A complete dislocation occurs when the bones lose direct contact with each other; in contrast, in partial dislocation (painful pronation or elbow subluxation), some of the elbow bones still maintain a slight connection.

For a complete elbow dislocation to occur, the trauma must be forceful and significant. Sometimes, elbow dislocations can lead to other associated complications such as fractures, nerve injuries (ulnar or median nerve), arterial injuries (brachial artery), among others.

SYMPTOMS OF ELBOW DISLOCATION

Síntomas De La Luxación De Codo

The symptoms accompanying a complete elbow dislocation include:

Intense and unbearable pain.

Arm deformity caused by joint displacement.

Functional impotence.

On the other hand, signs of partial or subluxated elbow dislocation are as follows:

Partial dislocation of the elbow.

Mild pain.

Bruising around the elbow.

Compromised elbow functionality.

TYPES OF ELBOW DISLOCATION

POSTERIOR ELBOW DISLOCATION

The majority of elbow dislocations (around 90%) fall into this category. The main causes include falls on the extended elbow and forearm in supination, as well as motor vehicle accidents.

Posterior elbow dislocation is a common elbow injury in sports such as cycling and skating.

ANTERIOR ELBOW DISLOCATION

This rare injury is caused by a fall or impact on the flexed elbow. Anterior elbow dislocation can lead to the anterior displacement of the ulna and the head of the radius, displacement of the elbow bones in front of the muscles, extensive ligament tears, or triceps avulsion.

LATERAL ELBOW DISLOCATION

Lateral elbow dislocation is a type of simple dislocation in which the arm bone (humerus) slides sideways and separates from the forearm bones (radius and ulna) in a lateral direction. This type of dislocation is usually the result of an injury or trauma to the elbow, such as a fall or a direct impact in the area.

TREATMENT FOR ELBOW DISLOCATION

Elbow dislocations require immediate attention from a doctor after the injury (or at least within the first 30 minutes). Usually, traction and contraction techniques are used to reduce the dislocation and restore elbow functionality.

Manipulating the dislocated elbow is painful and should be performed exclusively by a professional. The doctor is responsible for administering sedatives and analgesics to the dislocated patient to reduce pain throughout the procedure.

Once all reduction maneuvers are completed, a physical examination is performed to check the anteroposterior and mediolateral stability of the joint. Subsequently, radiographic studies are conducted on the joint and bone surfaces of the elbow to rule out additional internal complications.

Once the reduction is complete, 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 special exercise routine to gradually regain the range of motion of the joint and prevent the onset of stiffness. These controlled exercises are alternated with arm immobilization using a sling for an additional couple of weeks.

Luxacion De Codo Especialidades

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 recurrences.

RECOVERY TIME

If we count the first week with the splint after the dislocation, plus the two or three weeks following reduction, and add four weeks of controlled flexion and extension exercises, we can estimate that the temporary disability of the patient may last from 10 to 12 weeks in total.

If the dislocation was complex and required surgery for ligament reconstruction or other surgical procedures, this time may extend for many more months.

It is highly likely that your specialist will recommend ongoing follow-up, as complete elbow dislocations can lead to future instabilities that should not go unnoticed.

ELBOW DISLOCATION COMPLICATIONS

If a simple elbow dislocation is treated quickly and effectively, it usually does not lead to other complications. However, when dislocation is not treated promptly or medical recommendations are not fully followed, the patient may experience complications such as:

Stiffness:

Caused by prolonged immobilization.

Recurrence:

Experiencing frequent dislocations again.

Instability:

Caused by stretching of tendons and connective tissues.

RISKS OF INADEQUATELY TREATING AN ELBOW DISLOCATION

Elbow dislocation is considered an emergency injury, meaning that the patient must quickly seek medical attention after the traumatic event. But why is this so important? Complex elbow dislocation affects a significant portion of the elbow structures, ranging from fractures in any of the bones to the injury of nerves or blood vessels passing through the elbow, resulting in severe complications if not treated promptly.

Risk Factors

Some risk factors that can increase the likelihood of elbow dislocation include:

Luxacion De Codo Tratamiento Especialidades

Trauma or injury:

A direct blow to the elbow or a fall with the elbow extended can significantly increase the risk of dislocation.

Sports or recreational activities:

Participating in contact sports or activities involving sudden arm movements, such as rugby or snowboarding, increases the risk of elbow injuries, including dislocation.

Weakness or laxity in ligaments:

If the ligaments supporting the elbow joint (ulnar collateral ligament and radial collateral ligament) are weak or lax, the risk of dislocation is much higher.

History of previous dislocations:

If a person has experienced elbow dislocation in the past, they are more prone to suffer dislocation again.

Underlying medical conditions:

Some diseases or conditions such as arthritis or osteoporosis can weaken the bones and raise the chances of dislocations.

Frequently Asked Questions

In most cases, elbow dislocations go through a period of immobilization with a splint for 2 or 3 weeks. Subsequently, controlled flexion and extension movements of the elbow will be initiated, alternated with an orthopedic brace for an additional 4 weeks. This leaves us with an estimated recovery time between 10 and 12 weeks, depending on the patient’s progress.

Dislocations can be simple or complex depending on the aggressiveness of the trauma that caused them. In this regard, a simple dislocation can recover in a short time with conservative treatments. However, a complex dislocation can present a completely different scenario, as elbow bones, nerves, or blood vessels may be compromised, leading to much greater functional impotence.

The most recommended sleeping position with an elbow dislocation is lying on your back. To do this, you should place a pillow next to your body to support the affected arm. Some people also opt to sleep in a reclining chair to keep the arm in a neutral position, making rest more comfortable.

Surgical procedures are usually reserved for patients with complex dislocations that involve bone fractures, nerve damage, blood vessel injuries, tears or ruptures of other tissues, and more. Surgery is also used for patients with chronic dislocations (dislocations that were not medically treated during the first few weeks), where the elbow has undergone internal changes such as joint fibrosis and heterotopic calcifications that hinder closed reduction maneuvers.

Diagnosis of Elbow Dislocation

The diagnosis of elbow dislocation is generally made through a clinical evaluation accompanied by diagnostic imaging tests.

Medical history and physical examination:

The doctor will gather information about the symptoms and the patient’s medical history. Then, they will conduct a physical examination to assess the elbow joint for signs of dislocation, such as deformity, swelling, intense pain, and limited range of motion.

X-rays:

X-rays are a common diagnostic tool for assessing elbow dislocations. These images can help confirm the presence of a dislocation and determine the severity of the injury.

Diagnóstico De Una Luxación De Codo

Magnetic Resonance Imaging (MRI):

In some cases, magnetic resonance imaging may be used to obtain more detailed images of the soft tissues around the elbow. This can be useful for evaluating additional injuries such as damage to ligaments or tendons.

Computed Tomography (CT):

In more complex situations or when there is suspicion of bone injuries, a computed tomography scan may be performed to obtain cross-sectional images of the elbow.

Common Causes of Elbow Dislocations

Some common causes of elbow dislocations include:

Direct trauma:

A strong blow or direct force to the elbow can cause dislocation.

Sports injuries:

Sports activities involving abrupt movements, such as football, rugby, or gymnastics, can increase the risk of elbow injuries, including dislocation.

Abrupt or sudden movements:

Abrupt or sudden movements of the elbow, such as twisting or hyperextension, can also cause dislocation.

Entrapment injuries:

In some cases, the elbow can get trapped or locked in a forced position, resulting in dislocation.

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