The elbow is the second most commonly dislocated joint next to the shoulder and accounts for nearly 1/4 of all elbow injuries. Nearly 80% occur where the forearm shifts backward on the arm (humerus) bone. While there are several ways to dislocate it, the most common is the result of a fall on an outstretched hand.
The elbow is made up of the arm bone, or humerus, and the forearm bones: the radius and ulna. The ulna and humerus forms the hinge of the elbow, while the radius rotates and lets you turn your palm up and down. It is a very stable joint and hard to dislocate.
When a dislocation occurs, all of the ligaments that hold the elbow together are torn. Sometimes a small (or large) fracture can occur as well. In the absence of a break, the treatment is to pull the elbow back into the joint (along with some good pain medications) and let it heal. When the break occurs, the stability can be harder to achieve and sometimes there is a need for surgical treatment.
Treatment of a simple dislocation
The first step is to put the joint back in place as quickly as possible after the injury. This usually takes place in an emergency room with some good medications to make the procedure tolerable. Evaluation by an orthopedist with special training in sports injuries is helpful. Most dislocations can be kept in a splint or sling for 7-10 days and then range of motion exercises can begin. Assessing the degree of stability is important. These exercises will progress to improve range of motion over several weeks, and then start a strengthening program to get back to normal.
Challenges with dislocations
Elbows love to get stiff after injury. This means it can be hard to get all your normal movement back. This is why quick evaluation by an orthopedist is important, as well as the right kind of therapy. With the right treatment, there will not likely be any limitations. Injury to the joint surfaces usually occurs with a dislocation. This may not be a problem for several years or more (maybe never).
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More complicated dislocations
Rarely, a dislocation may involve fractures, or breaks in the bones around the elbow. This makes the picture much more complicated and often means a surgery will be needed to get things back together. Again, stiffness is still the long term complication so we want to put you together so you can start working on flexibility as quickly as possible.
Dr. Scott Hacker is a Sports Medicine Orthopedic Surgeon in San Diego, CA, Team Surgeon to the US Olympic Team. He specializes in sports medicine and sports injuries, knee and shoulder surgery.
If you have questions about elbow dislocations, or have a elbow dislocation, please feel free to contact me at Ask Dr. Hacker or through my office.
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