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Elbow dislocation

Last updated: November 5, 2020

Summary

The elbow is the second most commonly dislocated joint after the shoulder. A fall on an outstretched hand is the usual mode of injury. Complex elbow dislocations have an associated fracture, while simple elbow dislocations do not. Clinical features include pain and swelling of the joint and an inability to flex/extend the elbow. Examination reveals a loss of the triangular orientation between the medial and lateral epicondyles of the humerus and the olecranon process of the ulna. X-rays of the elbow joint confirm a dislocation and may show a positive fat pad sign. Simple elbow dislocations can be managed conservatively with closed reduction and immobilization. Complex elbow dislocations require surgical intervention with open reduction and internal fixation. Complications of elbow dislocation include joint instability/contractures and heterotopic ossification.

Radial head subluxation is discussed in another article.

Epidemiology

References:[1]

Epidemiological data refers to the US, unless otherwise specified.

Etiology

References:[2]

Classification

References:[1][2]

Clinical features

References:[3][4][5][6][7]

Diagnostics

References:[1][2][8][9][10][11]

Treatment

References:[5][12][13][14][15]

Complications

We list the most important complications. The selection is not exhaustive.

References

  1. Elbow Dislocation. http://www.orthobullets.com/trauma/1018/elbow-dislocation. Updated: April 11, 2017. Accessed: April 11, 2017.
  2. Halstead ME. Elbow Dislocation. In: Young CC, Elbow Dislocation. New York, NY: WebMD. http://emedicine.medscape.com/article/96758. Updated: May 26, 2016. Accessed: April 11, 2017.
  3. Doherty TJ. Ulnar Neuropathy at the Elbow and Wrist. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/ulnar-neuropathy-at-the-elbow-and-wrist.Last updated: October 14, 2015. Accessed: February 14, 2017.
  4. Dislocations of the Elbow. http://www.wheelessonline.com/ortho/dislocations_of_the_elbow. Updated: June 28, 2016. Accessed: April 11, 2017.
  5. Chorley J. Elbow Injuries in Active Children or Skeletally Immature Adolescents: Approach. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/elbow-injuries-in-active-children-or-skeletally-immature-adolescents-approach.Last updated: February 23, 2016. Accessed: April 11, 2017.
  6. Guardia ChF III. Ulnar Neuropathy. In: Lorenzo N, Ulnar Neuropathy. New York, NY: WebMD. http://emedicine.medscape.com/article/1141515. Updated: July 20, 2016. Accessed: April 11, 2017.
  7. Slowik GM, Fitzimmons M, Rayhack JM. Closed elbow dislocation and brachial artery damage. J Orthop Trauma. 1993; 7 (6): p.558-561.
  8. Posterior Fat Pad Sign. https://radiopaedia.org/articles/posterior-fat-pad-sign. Updated: April 11, 2017. Accessed: April 11, 2017.
  9. Positive Fat Pad Sign: Elbow. http://learningradiology.com/notes/bonenotes/posteriorfatpad.htm. Updated: April 11, 2017. Accessed: April 11, 2017.
  10. Sandstrom CK. Imaging of Elbow Fractures and Dislocations in Adults. In: Chew FS, Imaging of Elbow Fractures and Dislocations in Adults. New York, NY: WebMD. http://emedicine.medscape.com/article/389069. Updated: May 13, 2015. Accessed: April 11, 2017.
  11. Elbow Dislocation. https://radiopaedia.org/articles/elbow-dislocation. Updated: April 11, 2017. Accessed: April 11, 2017.
  12. Reduction of the Posterior Dislocation. http://www.wheelessonline.com/ortho/reduction_of_the_posterior_dislocation. Updated: May 30, 2012. Accessed: April 11, 2017.
  13. Complex Elbow Dislocations. http://www.wheelessonline.com/ortho/complex_elbow_dislocations. Updated: January 22, 2015. Accessed: April 11, 2017.
  14. Posterolateral Approach to Elbow (Kocher). http://www.wheelessonline.com/ortho/posterolateral_approach_to_elbow_kocher. Updated: July 31, 2015. Accessed: April 11, 2017.
  15. Williams GR Jr, Ramsey ML, Wiesel SW. Operative Techniques in Shoulder and Elbow Surgery. Lippincott Williams & Wilkins ; 2010
  16. Müller M. Chirurgie für Studium und Praxis (2012/13). Medizinische Verlags- und Informationsdienste ; 2011