dislocation of the elbow

Question 1

Elbow dislocation
(1) Most common dislocation in _______ and third most common in ______
(2) Resulting from a ________
(3) 80% of elbow dislocations are _____
(4) Dislocations may be complete or perched
(5) ______ ligament is always disrupted

Answer 1

1) children / Adults
2) fall on an outstretched hand (FOOSH)
3) posterior
5) Lateral collateral

Question 2

Dx / Tx
Clinical symptoms
(1) Extreme pain
(2) Swelling
(3) Inability to bend elbow
Physical Exam
(1) Visual = Obvious deformity
(2) Palpation = Tenderness noted throughout joint
(3) ROM
–(a) No elbow flexion and extension
–(b) Supination and pronation severely limited
(4) Muscle Test
–(a) All motions will be limited by pain and inability to move joint.
(5) Neurovascular = Do not overlook this exam
–1) Possible neuropathy
–2) Check radial pulse and cap refill

Answer 2

Dislocation of the elbow
Treatment
(1) Ice
(2) Appropriate pain management
(3) Splint
(4) Consider emergency reduction if delayed MEDEVAC time or neurovascular
compromise.
(5) Repeat neurovascular check after reduction.
(6) Reduction

Question 3

Reduction should be performed as follows:
(a) Elbow extended to ___ degrees.
(b) Slow, steady ______ traction of forearm in line with long axis of humerus.
(c) Gentle pressure over _____ tip.
(d) Repeat _______ examination after reduction.

Answer 3

a) 45
b) downward
c) olecranon
d) neurovascular

Question 4

Referral Decisions/Red Flags
(1) ________ should be performed as soon as possible by an orthopedic surgeon - refer for treatment ASAP.
(2) Patients with neurovascular compromise or bony injury require immediate ________.
(3) Flexion contracture that limits activities of daily living (ADLs) requires further evaluation.

Answer 4

1) Reduction
2) referral/MEDEVAC