Elbow dislocation is a serious injury. It occurs when the bones of the forearm (radius and ulna) move out of place (from the bone of upper arm, the humerus).
These bones are held together by the ligaments and muscles.
The image below shows a particular type of dislocation at the elbow – a Monteggia Fracture-Dislocation.
Symptoms
A complete elbow dislocation is extremely painful and obvious. The arm will look deformed and and may have a weird twist at the elbow.
A partial dislocation can be difficult to detect. It usually happens after a car accident. As it is only partially dislocated, the bones may spontaneously moving back to their places and the arm appears normal. There may be pain and burising at the elbow joint. If the ligaments is not heal properly, the dislocation may recur over time.
Causes
Elbow dislocation usually occur when a person falls onto an outstretched hand (with elbow locking straight). When the hand hits the ground, the force is sent to the elbow which may cause the elbow move out of its socket.
Elbow dislocation is also common to happen in a car accidents when a person reach forward to cushion the impact.
Risk Factors
Some people are born with greater looseness in their ligaments. These people are at greater risk to dislocate their joints especially elbow and shoulder even with a small force. Apart from that, there are also people born with a shallow groove on ulna for the elbow joint to be glide. Thus, making these people have a slightly higher risk for dislocation. Nothing really can be done to fix the risk factors despite being more careful if diagnosed earlier.
Investigations
Upon coming to the clinic, the doctor will have a look and examine the dislocated elbow for tenderness, swelling and deformity. The doctor will also check for the blood circulation and wound if there is any.
If the blood vessels is injured, the hand will be cool to touch because of less warm blood reaching the hand. Beside that, the doctor will check the movement of the elbow and the numbness around the arm. This can be happen if there is any nerve damages.
The doctor will then organise an X-ray of the arm to help finding and confirm the dislocation. If the dislocation is difficult to be identified on X-ray, a CT or MRI will be organised.
Complications
There is an increased risk for arthritis of the elbow joint if:
- The alignment of the bones is not good
- The elbow does not track well
- The elbow continues to dislocate
- If there is also a fracture of your elbow joint
Good advices from the doctor and physical therapist need to be followed to prevent such complications.
Dislocations of the Elbow Joint can also affect your nerves and cause weakness and sensation problems in your wrist and hand.
Treatment
As mentioned before, an elbow dislocation needs emergency medical attention. The aim of the treatment is basically to return the bones to its place (socket joint) and restore the function.
Conservative
If the bone only partial displaced, the doctor in Emergency Department will try to put back the joint’s bones into the socket. Usually, two people are needed to perform this. Then, the elbow will be kept immobile in splint or sling for two or three weeks, followed by light exercises of the elbow. During this period, having a physiotherapist can be helpful.
Surgery
Not all elbow dislocation required surgery. Only the complex dislocation may be necessary benefit from the surgery to restore its alignment and repair the ligaments. If the blood vessel or nerves are damaged in the elbow dislocation, additional surgery or a longer surgery may be needed to repair those structures.
It can be difficult to keep the elbow joint in line. There is an increased risk for arthritis in the joint if it is not align properly, the elbow does track well or if the elbow continues to dislocate.
After the surgery, a splint may be needed to wear external hinge or devices for few weeks. This device protect against re-dislocation.
Seeking Advice
Your Family Doctor (GP)
If you’d had an elbow dislocation in the past, or are recovering from a previous dislocation, you can speak to your GP. He/she will be able to diagnose and help treat your problem, including:
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
F.A.Q. | Frequently Asked Questions
Would my elbow be able to get back its fully strength and function?
Some people may not be able to fully straighten the arm, even after physical therapy. Fortunately. the elbow can work very well even without full range of movement. The doctor or physiotherapist may add a strengthening exercises.
How can i prevent from getting arthritis in the elbow joint after dislocating my elbow?
Usually, you are not allow to move the dislocated elbow for two or three weeks, followed by a light exercises recommended by the doctors or the physical therapist. During this period, you are not allowed to pick up things that are heavier than a cup of tea. It is important to allow the elbow joint restore its function slowly otherwise the bones will align properly and dislocation may happen again. A follow up X-ray will be organised by the doctor to make sure the bones track well and align properly into the socket. The doctor may suggest to wear an external hinge or brace to protect re-dislocation.