Elbow dislocation

Question 1

Mechanism of injury

Answer 1

1. Axial loading

Question 2

Why emergency?

Answer 2

High possibility of neurovascular injury than shoulder dislocation

1. Ischemic limb
2. Median nerve injury: Ape-like hand, paralysis of thenar muscle
3. Ulnar nerve: Claw hand
4. Radial nerve: Wrist drop

“neuropraxia: nerve-stretched”
“6 hours time ischemic limb, if fingers can wait up to 24 hours”
warm ischaemic time? biar in rm
cold ischaemic time?

Question 3

Type

Answer 3

Simple : no fracture

Complex : with fracture

Question 4

Terrible triad

Answer 4

Radial head fracture
Posterior dislocation
Coronoid process fracture

“Lateral lig disrupted, anterior capsule injury, medial lig” disrupt primary stabilizers

Question 5

Management

Answer 5

1. CMR

Question 6

Reduction

Answer 6

1. Forearm supinated, apply traction, apply pressure to olecranon, counter traction

Question 7

Complication

Answer 7

Early

1. Vascular
2. Nerve

Late

1. Stifness (loss around 20 degree)
2. Heterotrophic ossification (x-ray after 4-6 weeks)
3. Recurrent dislocation
4. Osteoarthritis
5. Unreduced dislocation