Elbow dislocation: evaluation of different degrees, patient treatment and prevention

By Cristiano Antonino On May 26, 2023

An elbow dislocation occurs when the bones of the forearm – the radius and ulna – move out of place with respect to the humerus, the upper arm bone

In the case of particularly serious injuries, fractures can occur with the bones breaking.

Or there may be lesions in the arm arteries, which are the vessels that carry blood to the hand, and lesions in the nerves that pass through the elbow area.

In this case the movements are more difficult and the patient will not be able to feel the arm well or move it correctly.

Elbow dislocations are very common, second only to shoulder dislocations.

What are the different degrees of severity of an elbow dislocation?

Complications can occur if the dislocation affects the blood vessels and nerves that serve the lower arm and hand.

This is usually a lesion that is realigned without surgery and does not have serious consequences.

However, if the elbow is also fractured, surgery may be required.

In these cases, even the convalescence will be longer and more tiring, and it will take more time to recover the full functionality of the elbow than it takes for a simpler dislocation.

In adults and children the most common causes of elbow dislocation are

the falls
car accidents
improper movements

The classic falls with outstretched hands to try not to hit the ground violently are one of the main causes of elbow dislocation.

Arresting the fall with the palm of the hand is an instinctive gesture, but it can sometimes cause the arm bone to come out of alignment inside the elbow joint.

The chances of dislocating the elbow or, worse, breaking it, can be very high, especially in the case of adults.

But even for children and adolescents there is a high probability of injury in the event of such a fall.

The same type of injury can occur when passengers in a car involved in an automobile accident lean forward to prepare for a collision.

Also in this case pointing the hands forward is a spontaneous gesture, which however often leads to fractures and dislocations of the elbow.

You have to be very careful in the case of small children, who do not yet have perfectly formed joints and are generally weaker.

It happens that adults lift them, without paying attention, by the arms, making them stretch.

This gesture, which many believe to be harmless, can cause a child to dislocate an elbow.

Another very common way in which this injury occurs in toddlers is when the child is suddenly pulled, perhaps to get him off the curb or away from the road.

This too can bring the elbow out of alignment.

Symptoms and complications

Symptoms of elbow dislocation include extreme pain and obvious sprain of the joint.

Sometimes it can happen that the elbow is only partially dislocated: in this case there can be bruising around the area and pain where the ligaments have stretched.

The complications of a dislocated elbow can be different.

First, some bones may fracture as a result of the dislocation, and some nerves may be pinched.

The latter complication is rarer and less likely to happen, but it happens when the nerves running through the elbow become pinched or trapped between the dislocated bones, or within the joint when the bones are realigned.

In the case of pinched nerves, numbness in the arm and hand may be felt.

Another even rarer complication is that of arteries becoming pinched between dislocated bones or within the realigned joint.

The lack of blood supply caused by blood vessels under normal conditions can cause severe pain and, in the worst case, permanent tissue damage in the arm and hand.

Then there is the case where the elongated feature can pull a piece of bone away from its attachment point.

This damage is more common in children, which can cause a higher risk of developing osteoarthritis in the future.

Diagnosis

The doctor’s job is to carefully examine the injured joint and check whether or not the arm or hand feels tender in some places.

If checking a dislocation is quite immediate – the dislocation of the elbow is in fact very visible and there are few doubts about it – the matter is different for checking the arteries and nerves that could be injured.

As already indicated above, these are rarer possibilities that are very unlikely to happen.

In any case, a correct diagnosis must also take into account the most serious options and avoid a serious injury such as that which would occur in the case of pinched arteries and nerves.

If the doctor deems it necessary – and this happens in most cases – an X-ray is also carried out.

The goal of this test is to prevent fractures in the bones that make up the elbow joint.

What is the treatment for elbow dislocation?

In the best case scenario, the sprained elbow snaps back into place on its own.

This is obviously the least serious situation and the one that presents the least complications from a clinical point of view.

However, this is a small percentage of cases.

Most of the time, in fact, a doctor is needed to manipulate the bones and bring them back into their correct alignment.

This is now a routine procedure and is practiced in most cases where a patient presents with a dislocated elbow.

Sometimes the doctor may decide to give pain relievers to the patient before the manipulation.

In these cases the medicines not only have the function of decreasing the physical suffering experienced, but also of relaxing the muscles.

However, it is a choice at the discretion of the doctor: never take medicines if they have not been prescribed by the attending doctor.

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When the joints of the bones have returned to their normal alignment, you may need to wear a splint or sling for a few weeks.

In order to regain full elbow function, your doctor may recommend performing physical therapy exercises to improve the joint’s range of motion and strength.

In severe cases of elbow dislocation, surgery may be required.

This is expected when dislocated bones break or when torn ligaments need to be reattached.

An operation is also necessary when there are damaged nerves or blood vessels that need to be repaired.

Prevention

Although these events are sometimes unpredictable and there is nothing that can be done to avoid elbow dislocations, some small tricks can reduce the chances of getting hurt and having to resort to painful therapies and lengthy rehabilitations.

In the case of small children, who are obviously unaware of some movements that may be wrong, adults must avoid picking them up or lifting them by the arms.

This is one of the most common ways that little ones hurt and dislocate their elbow.

As far as adults are concerned, however, in the event of a fall, you must avoid putting your hands forward.

Not only do you risk breaking your hands and wrist, but also dislocating your elbow and undergoing long months of physiotherapy to regain full function in your arm.

If in the event of a fall this is one of the most spontaneous gestures, it is also one of the most dangerous.

Never put your hands forward, if you realize that you are about to fall it is better to throw yourself to the side and cushion the fall with the side of the blow, protecting your head at the same time.

In these cases it is good to always ask your sports instructor or personal trainer for clarifications, who will be able to illustrate the best ways to fall and avoid breaking or dislocating your bones.

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