The elbow is a complex joint that is extremely vulnerable to injury. Elbow dislocations require proper treatment to heal successfully. Learn about possible causes of elbow dislocations, and how they can properly be treated.
Your elbow is a unique joint. Through the elbow, the arm bends and the wrist rotates. These disparate functions are possible because the elbow joint works as both a hinge and a ball-and-socket joint. It is the complexity of the elbow that also makes it vulnerable to injury. The elbow is comprised of the two bones of the forearm (radius and ulna), which are joined to the upper arm bone (humerus) with a variety of ligaments.
When the joint comes out of proper alignment, it is called a dislocation. When the joint’s surfaces separate either partially or completely, it can affect the ligaments, tendons, and muscles that support and strengthen the joint. A separation can also affect the bones, nerves, and blood vessels. Simple dislocations involve minimal damage to the surrounding tissues; however, once the elbow is reduced it does not require surgical repair of the soft tissues. Complex dislocations involve damage to the bone and ligaments surrounding the elbow and will require surgical stabilization.
“It is the complexity of the elbow that also makes it vulnerable to injury.”
If you have a complete elbow dislocation, you will know it immediately. An elbow dislocation causes severe pain, deformity, and an inability to move the elbow. It can also cause the elbow to become extremely swollen. Meanwhile, a partial dislocation is more subtle. You will feel some pain and notice bruising, and your elbow may seem to function normally. But this can be deceptive, as the ligaments may have been damaged. And if they do not heal properly, you are more likely to suffer future problems with the joint, including additional dislocations.
Elbow dislocations happen as a result of injury or trauma, often when the arm is attempting to cushion a fall or protect the body from a frontal impact. In such cases, force travels from the hand or forearm into the elbow joint, forcing the bones to rotate and subsequently dislocate. Sports associated with elbow dislocations include gymnastics, wrestling, and football.
There can also be a genetic component to elbow dislocations (and joint dislocations in general). The laxity of your ligaments can be an inherited trait. If you have more relaxed ligaments, they are less effective at supporting the joint and dislocations are more likely to occur.
In order to diagnose a dislocated elbow, a doctor will perform a physical exam, looking at the arm and moving the joint. Doctors usually will use an x-ray to visualize the joint separation, and in some cases, they may use an MRI or CT scan to look for damage to the surrounding tendons and muscles, as well as small fractures in the joint that can be missed on an x-ray.
Nonsurgical treatment options
After an elbow dislocation, the first priority is restoring the proper alignment of the bones. To properly treat a dislocated elbow, patients require adequate pain control to relax their muscles. Once the elbow joint is reduced (the dislocated bones are popped back into place), if the elbow joint can be moved through its range of motion without re-dislocating, surgery likely can be avoided and physical therapy is started. However, if the elbow is reduced but remains unstable (meaning it will immediately slip out of normal alignment), it cannot be reduced at all, or there is severe damage to the surrounding tissues, then surgery is needed.
How surgery is performed
Elbow surgery can be performed to fix an unstable elbow and repair torn ligaments, broken bones, or damage to nerves. The surgery is open, meaning a cut in the skin is made. Repairing bone can involve the use of metal plates that are secured in place with screws. In severe cases, the use of an external hinged brace is used to support the elbow after surgery as the bone and ligaments heal.
“Recovery times will vary depending on the severity of the injury and whether or not it affected the patient’s dominant arm.”
Recovery times will vary depending on the severity of the injury and whether or not it affected the patient’s dominant arm. For simple dislocations that have been properly treated, recovery normally takes three to six weeks. For more severe dislocations or cases that involve other injuries (like damage to the bones and ligaments), recovery can take up to six months. During the healing process, patients will first focus on regaining motion and later focus on strengthening the arm. Therapeutic exercise is essential in reaching both of these goals, so patients should be guided with a specific program throughout their recovery. This program will be provided by an occupational or physical therapist who has a special interest in elbow injuries.
While each person’s recovery time is dependent on various factors, most patients with elbow dislocations will be able to successfully reach a full recovery, returning to their normal daily activities. The most common lingering problem is elbow stiffness, which may be permanent if not resolved by six months after the injury.
Is it possible to regain full motion after an elbow dislocation?
It is possible to regain full range of motion, but this requires immediate attention to the original injury and a well-structured program to regain range of motion without compromising stability of the elbow.
For more information about causes and treatment of elbow dislocation, please request an appointment with experienced Chicago orthopaedic surgeon Dr. Anthony Romeo. Call our office today to schedule your visit.
Anthony Romeo, MD
Dr. Anthony Romeo is one of the nation’s leading orthopaedic surgeons specializing in the management and surgical treatment of shoulder and elbow conditions. His state-of-the-art practice employs minimally-invasive arthroscopic techniques to accelerate the recovery process for a range of challenging conditions.