elbow ELBOW DISLOCATION
DEFINITION:
- The separation of the humerus from the ulna/radius. (See illustration).
MECHANISM OF INJURY / HOW IT OCCURS:
- Usually the result of a fall on the outstretched upper extremity with disruption of the surrounding soft tissue envelope.
SYMPTOMS:
- Individuals complain of immediate pain and deformity.
- Inability to move the elbow.
DIAGNOSIS:
- Physical examination reveals deformity to the elbow.
- Limited motion and swelling.
- Evaluate for neurovascular injury assessing motor and sensory function in addition to pulses as damage to a nerve or artery may occur. (Perform this evaluation both pre and post reduction).
- Radiographic studies will define the direction of the dislocation (usually posterior), and evaluate for possible concomitant fracture. (Perform studies both pre and post reduction).
TREATMENT/REHABILITATION:
- Relocation in the emergency room with sedation. May require general anaesthesia in difficult cases.
- Splint after reduction avoiding flexion over 100 degrees as this can result in vascular compromise.
- Early range of motion exercises approximately 7 days after injury so as to avoid stiffness.
- Anti inflammatory medications (NSAIDS).
- Possible bracing if instability exists at the extremes of motion.