Elbow Dislocation

ExitCare ImageElbow dislocation is the displacement of the bones that form the elbow joint. Three bones come together to form the elbow. The humerus is the bone in the upper arm. The radius and ulna are the 2 bones in the forearm that form the lower part of the elbow. The elbow is held in place by very strong, fibrous tissues (ligaments) that connect the bones to each other.

CAUSES

Elbow dislocations are not common. Typically, they occur when a person falls forward with hands and elbows outstretched. The force of the impact is sent to the elbow. Usually, there is a twisting motion in this force. Elbow dislocations also happen during car crashes when passengers reach out to brace themselves during the impact.

RISK FACTORS

Although dislocation of the elbow can happen to anyone, some people are at greater risk than others. People at increased risk of elbow dislocation include:

  • People born with greater looseness in their ligaments.

  • People born with an ulna bone that has a shallow groove for the elbow hinge joint.

SYMPTOMS

Symptoms of a complete elbow dislocation usually are obvious. They include extreme pain and the appearance of a deformed arm.

Symptoms of a partial dislocation may not be obvious. Your elbow may move somewhat, but you may have pain and swelling. Also, there will likely be bruising on the inside and outside of your elbow where ligaments have been stretched or torn.

DIAGNOSIS

To diagnose elbow dislocation, your caregiver will perform a physical exam. During this exam, your caregiver will check your arm for tenderness, swelling, and deformity. The skin around your arm and the circulation in your arm also will be checked. Your pulse will be checked at your wrist. If your artery is injured during dislocation, your hand will be cool to the touch and may be white or purple in color. Your caregiver also may check your arm and your ability to move your wrist and fingers to see if you had any damage to your nerves during dislocation.

An X-ray exam also may be done to determine if there is bone injury. Results of an X-ray exam can help show the direction of the dislocation.

If you have a simple dislocation, there is no major bone injury. If you have a complex dislocation, you may have broken bones (fractures) associated with the ligament injuries.

TREATMENT

For a simple elbow dislocation, your bones can usually be realigned in a procedure called a reduction. This is a treatment in which your bones are manually moved back into place either with the use of numbing medicine (regional anesthetic) around your elbow or medicine to make you sleep (general anesthetic). Then your elbow is kept immobile with a sling or a splint for 2 to 3 weeks. This is followed with physical therapy to help your joint move again.

Complex elbow dislocation may require surgery to restore joint alignment and repair ligaments. After surgery, your elbow may be protected with an external hinge. This device keeps your elbow from dislocating again while motion exercises are done. Additional surgery may be needed to repair any injuries to blood vessels and nerves or bones and ligaments or to relieve pressure from excessive swelling around the muscles.

HOME CARE INSTRUCTIONS

The following measures can help to reduce pain and hasten the healing process:

  • Rest your injured joint. Do not move it. Avoid activities similar to the one that caused your injury.

  • Exercise your hand and fingers as instructed by your caregiver.

  • Apply ice to your injured joint for 1 to 2 days after your reduction or as directed by your caregiver. Applying ice helps to reduce inflammation and pain.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15 to 20 minutes at a time, every couple of hours while you are awake.

  • Elevate your arm above your heart and move your wrist and fingers as instructed by your caregiver to help limit swelling.

  • Take over-the-counter or prescription medicines for pain as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your splint becomes damaged.

  • You have an external hinge and it becomes loose or will not move.

  • You have an external hinge and you develop drainage around the pins.

  • Your pain becomes worse rather than better.

  • You lose feeling in your hand or fingers.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.