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Dislocated Elbow

Dislocated elbow facts

Signs and symptoms of a dislocated elbow include a visible deformity, pain, and swelling.
Signs and symptoms of a dislocated elbow include a visible deformity, pain, and swelling.
  • A dislocated elbow occurs when the radius (or radius head) and/or ulna bones of the forearm are moved out of place with the humerus (upper arm) bone that together form a joint.
  • There are many types of elbow dislocations, but about 90% are posterior types.
  • Causes are trauma usually due to falling with an outstretched arm. In children (less than about 4-5 years old), it is termed radial head subluxation or nursemaid's elbow and is caused by jerking or pulling on an outstretched arm.
  • Other causes are accidents and sports activities.
  • Signs and symptoms in older children and adults include
    • a visible deformity,
    • a pop sound at the time of injury,
    • pain,
    • swelling,
    • stiffness,
    • unable to bend the elbow,
    • bruising, and
    • numbness/weakness in the arm, wrist, and/or hand.
  • Doctors make a diagnosis using observation, X-rays, CT, and/or ultrasound.
  • Reduction of the dislocated elbow is the major treatment of a dislocated elbow.
  • Elbow dislocation complications may involve bone fractures, blood vessel and/or nerve problems, compartment syndrome, and others.
  • The prognosis is good for uncomplicated elbow dislocations treated appropriately.
  • Recovery times vary from about 3 weeks to 3 months depending upon the individual's elbow usage. Complications take longer.
  • It is possible to reduce the risk of a dislocated elbow.

What is a dislocated elbow? What are the types of elbow dislocations?

An elbow dislocation is when the forearm bones (radius and ulna) move out of place relative to their articulating joint formation with the humerus bone of the upper arm. There are several types of elbow dislocations based on their location and complexity:

  • Simple
  • Complex (involving bone fracture[s] and/or other problems)
  • Posterior (about 90% of all elbow dislocations)
  • Anterior
  • Lateral
  • Partially displaced

In young children (ages less than about 4-5 years), the elbow dislocation is termed a radial head subluxation or nursemaid's elbow.

What are the causes and risk factors of a dislocated elbow?

Falling onto an outstretched hand or a traumatic event like a car accident commonly cause an elbow dislocation. Risk factors include contact sports, gymnastics, rollerblading, and similar activities. In children, radial head subluxations may occur when the child's elbow is extended and then pulled or yanked (for example, pulling a child up off the floor by the child's arm, wrist, or hand).

What are the signs and symptoms of a dislocated elbow?

The signs and symptoms of a dislocated elbow begin quickly after a dislocation and may include

  • a visible deformity,
  • a pop sound at the time of injury,
  • pain,
  • swelling,
  • stiffness,
  • inability to bend the elbow,
  • bruising,
  • numbness/weakness in the arm, wrist, and/or hand.

In children with nursemaid's elbow, signs and symptoms may include immediate pain in the injured arm/elbow, anxiety, and refusal or inability to move the injured arm/elbow. Usually, there is no sign of serious injury (no deformity, swelling, or bruising).

How do doctors diagnose a dislocated elbow?

Doctors use X-rays (anteroposterior and lateral films) and CTs to diagnose a dislocated elbow. Many doctors take X-rays before and after the elbow undergoes reduction (being put back in its normal position). Medical professionals usually use CT and ultrasound with more complex dislocations. Unless there are indications of bone fractures, doctors do not use X-rays to diagnose a nursemaid's elbow. They use a patient's history and physical exam to make a diagnosis.

What are treatments and home remedies for a dislocated elbow?

Medical professionals should reduce the displacement as soon as possible to help avoid complications and minimize the time to recover in both children and adults. Rehab may be helpful for many adults after elbow joint reduction. Some patients may require an elbow brace to reduce discomfort from nerve pain. Some patients require oral pain medications. Discuss home remedies like ice, heat, and rest with your doctor after elbow reduction.

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What are complications of a dislocated elbow?

Complications of an elbow dislocation may include

Untreated nursemaid's elbow may result in a limited ability to move the elbow.

What is the prognosis and recovery time for a dislocated elbow?

Early treatment (reduction of the dislocation) and follow-up rehab of the dislocated elbow can result in a good prognosis. Long delays of reduction and complications can reduce the prognosis. Recovery times vary. An appropriately treated simple dislocation may recover in 3-6 weeks, but if the elbow joint is in the pitching arm, throwing recovery may take up to 3 months. Any complications increase recovery times.

Is it possible to prevent a dislocated elbow?

It may be possible to prevent some dislocations by avoiding risk factors. Wear protective gear while doing any activities that could cause a fall on an outstretched arm and do not pick up or swing a baby, toddler, or young child by an arm.

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Reviewed on 12/30/2019
References
Halstead, M. "Elbow Dislocation." Medscape.com. Sept. 26, 2017. <https://emedicine.medscape.com/article/96758-overview>.
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