An elbow dislocation occurs when the bones of the forearm (the radius and ulna) move out of place compared with the bone of the arm (the humerus). The elbow joint, formed where these three bones meet, becomes dislocated, or out of joint.
Specific, serious injuries that can accompany elbow dislocation include breaking of the bones (fractures), injuries to the arteries in the arm (the vessels carrying blood to the hand), and injuries to the nerves that run through the elbow area, impairing movement and feeling in the arm and hand.
The doctor will examine the arm. He will check for tenderness, swelling, and deformity. He will evaluate the skin and circulation to the arm. Pulses at the wrist will be checked. If the artery is injured at the time of dislocation, the hand will be cool to touch and may have a white or purple hue. This is caused by the lack of warm blood reaching the hand. X-rays are the best way to confirm that the elbow is dislocated. If bone detail is difficult to identify on an X-ray, a computed tomography (CT) scan may be done. If it is important to evaluate the ligaments, a magnetic resonance image (MRI) can be helpful.
Simple elbow dislocations are treated by keeping the elbow immobile in a splint or sling for two to three weeks, followed by early motion exercises. If the elbow is kept immobile for a long time, the ability to move the elbow fully (range of motion) may be affected. Physical therapy can be helpful during this period of recovery. In a complex elbow dislocation, surgery may be necessary to restore bone alignment and repair ligaments. It can be difficult to realign a complex elbow dislocation and to keep the joint in line. After surgery, the elbow may be protected with an external hinge. This device protects the elbow from dislocating again. If blood vessel or nerve injuries are associated with the elbow dislocation, additional surgery may be needed to repair the blood vessels and nerves and repair bone and ligament injuries.
The prevalence of posterior dislocation was 1.1 per 100,000 population per year, with peaks in male patients between twenty and forty-nine years old, and in the elderly patients over seventy years old. Most dislocations (67%) were produced by a traumatic accident, with most of the remainder produced by seizures. Twenty patients (twenty-three shoulders) developed recurrent instability. On survival analysis, 17.7% (95% confidence interval, 10.8% to 24.6%) of the shoulders developed recurrent instability within the first year. On multivariable analysis, an age of less than forty years, dislocation during a seizure, and a large reverse Hill-Sachs lesion (>1.5 cm3) were predictive of recurrent instability. Small persistent functional deficits were detected with the WOSI and DASH at two years.