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of the Adult's Elbow > Dislocation of the Elbow in the Adult What is Dislocation of the Elbow? The elbow is the place where arm (the humerus) and the lower arm (the ulna) join. A dislocation involves the separation of the joint by stretching or tearing of the ligaments. A functioning elbow joint is capable of both mobility and stability, displaying an elegant combination of the two. Because the joint is basically stable, it requires considerable force to dislocate the elbow. For this reason, as many as one third of all elbow dislocations involve fractures to the elbow bones. Dislocation of the elbow is the most common type of dislocation injury in children. In adults, it is second only to shoulder dislocation, and occurs most often in men. Dislocation injuries are frequently associated with bone fractures or damage to surrounding muscles, ligaments, and nerves. Causes of Dislocation of the Elbow? Nearly half of these injuries are the result of sports activities, often to adults between the ages of 25 and 30. Posterior dislocations of the elbow are most frequently caused by a fall onto an outstretched hand. An example would be a backwards fall onto a hip or buttock while roller-blading, with the arm extended backward to break the fall. While it is difficult to prevent many such accidents, it is wise to wear protective elbow pads while taking part in sports in which you may fall or otherwise get injured. A previously injured elbow joint can be protected by wrapping it with elastic bandage. Symptoms of Dislocation of the Elbow? If you have dislocated your elbow, you will feel intense pain around the elbow joint, and loss of grip. Dislocations are true emergencies. The joint will display an extremely limited range of motion. There will be pain in the shoulder or wrist if there are associated injuries to these parts of the body. Rarely the circulation to the extremity may be impaired. A dislocated elbow joint is misshapen, swollen, and very painful. It may be discolored. Sometimes it is hard to tell a dislocation from a broken bone. Treatment of Dislocation of the Elbow? Ice the injury as soon as possible and seek treatment immediately. Icing relieves pain and helps slow blood flow, reducing internal bleeding and swelling. Do not attempt to put a dislocated bone back into its socket, as this can result in further damage to surrounding tissue or nerves. If possible, splint the limb in the position found immediately after the injury occurred, and feel for the pulse at the wrist. Your doctor will take x-rays to evaluate the injury and examine the elbow for neurovascular damage. The motor function of the medial, radial, and ulnar nerves of the arm will be assessed. Your pulse will be taken and sensation of the arm, hand, and fingers evaluated. You will be asked to supply information about previous injuries to the arm, wrist, shoulder, and hand. After a complete evaluation of your injury, your doctor (often with the assistance of a second medical professional) will put the bones back into their normal position. Local or general anesthetic is commonly used during this procedure. The injured parts of the arm are gently repositioned, and a cast or splint is required to hold the bones in their natural position. The splint prevents the joint from moving while it heals. In the most severe cases, marked by extreme force, massive swelling, or wide separation of the joint, there may be injury to the brachial artery, the artery that services the arm. If there is a loss of sensation following the repositioning of the displaced bones, nerve entrapment may have occurred. In these cases a surgery may be necessary. Your doctor will probably prescribe a pain reliever and muscle relaxant. In the case of most elbow dislocations, splints are removed after 5 to 7 days. More severe injuries may require using a splint for as long as two weeks. You may be asked to use pillows to keep your elbow elevated whenever possible; this helps prevent and reduce swelling. In some cases an ice pack is placed on the affected area for 20 minutes two or three times a day. Rest the injury as much as possible. Expect recovery from this serious injury to take at least 4-6 weeks. Once the splint is removed your doctor will demonstrate various range-of-motion exercises to assist in recovery. Range-of-motion exercises for your wrist, fingers, and shoulder are also necessary to prevent stiffness and long-term damage to the elbow joint. In spite of active rehabilitation, loss of motion, especially extension, may occur. Full treatment of dislocation of the elbow is essential in order to prevent loss of motion to this joint, particularly in the ability to straighten and extend the arm. Complications of the injury may include associated neurovascular damage or the eventual development of arthritis of the elbow joint. An intensive and coordinated rehabilitation program is your best protection against damage resulting in limited extension and flexion of the elbow joint. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |