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 may have an abnormal 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 move back into place and the arm appears normal. There may be pain and bruising at the elbow joint. If the ligaments do not heal properly, the dislocation may recur over time.
Causes
Elbow dislocation usually occurs 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 to move out of its socket.
Elbow dislocation also commonly happens in car accidents when a person reaches forward to cushion the impact.
Risk Factors
Some people are born with greater looseness in their ligaments. These people are at greater risk of dislocating their joints, especially the elbow and shoulder, even with a small force. Apart from that, there are also people born with a shallow groove on the ulna for the elbow joint to glide in, giving these people a slightly higher risk of dislocation. Nothing can be done to change these risk factors, other than being more careful if they are diagnosed early.
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 are injured, the hand will be cool to touch because of less warm blood reaching the hand. Besides that, the doctor will check the movement of the elbow and the numbness around the arm. This can happen if there is any nerve damage.
The doctor will then organise an X-ray of the arm to help find and confirm the dislocation. If the dislocation is difficult to identify 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 advice from the doctor and physical therapist needs 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 their place (socket joint) and restore the function.
Conservative
If the bone is only partially 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 dislocations require surgery. Only complex dislocations may benefit from surgery to restore 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 aligned properly, the elbow does not track well or if the elbow continues to dislocate.
After the surgery, you may need to wear a splint, external hinge or other device for a few weeks. This protects against re-dislocation.
Seeking Advice
Your Family Doctor (GP)
If you’ve 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
Will my elbow get back its full 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 strengthening exercises.
How can I prevent from getting arthritis in the elbow joint after dislocating my elbow?
Usually, you are not allowed to move the dislocated elbow for two or three weeks, followed by 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 not 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 wearing an external hinge or brace to protect against re-dislocation.