elbow dislocation

Question 1

what are the types of elbow dislocation?

Answer 1

simple or complex

complex is associated with another fracture.

Question 2

what direction do elbow dislocation ocour?

Answer 2

posteriorly

50/50 chance of bony injury

Question 3

what are the clinical features of elbow dislocations?

Answer 3

• high energy fall
• painful, deformed joint with swelling and decreased function
• NV examination is needed, with deficit usually found in ulnar nerve territory as neuropraxia of nerve is common
• good capillary refil due to rich collateral circulation

NB any concern over pulse will warrant a doppler ultrasound

Question 4

what investigations are done in elbow dislocations?

Answer 4

• presenting with significant trauma, you should resuscitate, investigate and manage as per ATLS protocols
• plain film radiograph of elbow, AP and lateral

Question 5

how elbow dislocations managed?

Answer 5

• closed reduction under analgesia/sedation if appropariate
• above elbow backslab once reduced to keep elbow at 90 degrees
• treat associated fractures if present
• simple dislocations can be treated as outpatient and early rehabilitation is encouraged
• complicated fractures may need an operative fix, which involves open reduction and internal fixation (ORIF).

Question 6

what are the complications of elbow dislocations?

Answer 6

• early stiffness with loss of terminal extension
• common neurovascular injury is stretching of the ulnar nerve
• recurrent instability

Question 7

what is the terrible triad?

Answer 7

an elbow dislocation with

1. lateral collateral ligamernt injury
2. radial head fracture
3. coronoid fracture

causing a very unstable elbow with a poor outcome. treatment revolves around operative fixation