alexa Dislocated elbow | Norway | PDF | PPT| Case Reports | Symptoms | Treatment

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Dislocated Elbow

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  • Dislocated elbow

    When the joint surfaces of an elbow are separated, the elbow is dislocated. Elbow dislocations can be complete or partial. In a complete dislocation, the joint surfaces are completely separated. In a partial dislocation, the joint surfaces are only partly separated. A partial dislocation is also called a subluxation.

    Symptoms

    Severe pain in the elbow, swelling, and inability to bend your arm are all signs of an elbow dislocation. In some cases, you may lose feeling in your hand or no longer have a pulse (can't feel your heartbeat in your wrist). Arteries and nerves run by your elbow, so it is possible you might have injured them during the dislocation.

  • Dislocated elbow

    Diagnosis

    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. An X-ray is necessary to determine if there is a bone injury. X-rays can also help show the direction of the dislocation. 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.

  • Dislocated elbow

    Treatment

    An elbow dislocation should be considered an emergency injury. The goal of immediate treatment of a dislocated elbow is to return the elbow to its normal alignment. The long- term goal is to restore function to the arm.

    Nonsurgical Treatment - The normal alignment of the elbow can usually be restored in an emergency department at the hospital. Before this is done, sedatives and pain medications usually will be given. The act of restoring alignment to the elbow is called a reduction maneuver. It is done gently and slowly. Two people are usually required to perform this maneuver. 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. Some people will never be able to fully open (extend) the arm, even after physical therapy. Fortunately, the elbow can work very well even without full range of motion. Once the elbow's range of motion improves, the doctor or physical therapist may add a strengthening program. X-rays may be taken periodically while the elbow recovers to ensure that the bones of the elbow joint remains well aligned.

    Surgical Treatment -  A complex dislocation of the elbow.In addition to dislocation, there are multiple fractures of the elbow.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.

  • Dislocated elbow

    Epidemiology

    Sex: Elbow dislocation injuries occur more often in males than in females. Age: Dislocations occur more commonly in adults, since the same force in children more often results in a supracondylar fracture of the distal humerus. The Norway elbow prosthesis is a non-constrained cemented total replacement. It depends on intact collateral ligaments for stability, and allows a full range of movement. The system includes several sizes of components, all freely interchangeable, and semi-constraint can be provided by a locking ring if damaged collateral ligaments make dislocation possible. The prosthesis has been used in more than 350 elbows in Norway and the detailed results for 118 elbows studied prospectively since 1987 are reported. It is inserted through a posterolateral triceps-splitting incision with minimal muscle disruption and bone resection, preserving the collateral ligaments. The results as regards pain relief and range of movement were comparable with those of other elbow prostheses, but there were fewer serious complications. At a mean follow-up of 4.3 years, the failure rate was 3.4%.

 

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