Elbow Dislocation
Adelaide-Based Orthopaedic Treatment
Elbow dislocation is a significant injury that occurs when the bones of the forearm (radius and ulna) are forced out of alignment with the humerus (upper arm bone) at the elbow joint. It is a traumatic injury that can cause severe pain, instability, and limited arm function. In some cases, the elbow dislocation can be part of a more complex injury pattern known as the “terrible triad”, which involves additional fractures around the elbow joint. Understanding the causes, symptoms, and treatment options for elbow dislocation injuries, including the terrible triad, is essential for proper management and recovery.
Causes of pathology
Elbow dislocation injuries can result from various factors, including:
- Trauma: A forceful impact, such as a fall, car accident, or sports-related collision, can cause the elbow joint to dislocate.
- Hyperextension: Overextending the elbow joint beyond its normal range of motion, often seen in sports or accidental injuries, can lead to dislocation.
- Terrible triad injury: The terrible triad refers to a specific pattern of elbow injury that includes an elbow dislocation, along with fractures of the radial head (head of the radius bone) and coronoid process (a projection of the ulna bone). This complex injury pattern requires specialised treatment and management.
Symptoms
Elbow dislocation injuries may present with the following symptoms:
- Severe pain: Intense pain in the elbow joint and surrounding area.
- Swelling and bruising: Swelling and bruising around the elbow due to tissue damage and inflammation.
- Visible deformity: The elbow joint may appear visibly deformed or out of place.
- Limited range of motion: Inability to move the elbow normally due to pain and joint instability.
- Numbness or tingling: Numbness or tingling in the hand or fingers, which may indicate nerve involvement.
Treatment options
Non-operative treatment
Non-operative treatment options for elbow dislocation injuries may be considered for certain cases, particularly when there are no associated fractures or severe ligament damage. Non-operative treatment may include:
Closed reduction: The healthcare provider manually manoeuvres the bones back into their proper alignment, often under sedation or anaesthesia.
Immobilisation: After reduction, the elbow may be immobilised using a splint or cast to allow the injured structures to heal.
Rehabilitation: Once the acute phase has passed, a physical therapy program may be initiated to improve elbow strength, stability, and range of motion.
Operative treatment
Operative treatment is often necessary for severe elbow dislocations, especially those involving the terrible triad injury pattern or significant ligament damage. Surgical intervention aims to restore the normal alignment of the elbow joint and address associated fractures. Surgical options may include:
Open reduction and internal fixation (ORIF): The surgeon uses open surgical techniques to reposition the bones and fix them in place using plates, screws, or other hardware.
Ligament repair or reconstruction: If the ligaments around the elbow are severely damaged, they may require repair or reconstruction using grafts or other techniques.
Radial head arthroplasty or replacement: In some cases, the damage to the radial head is too severe, and the best option is a radial head replacement. The damaged radial head bone is removed and replaced with a size-matched prosthesis made from pyrocarbon.
Rehabilitation: Following surgery, a structured rehabilitation program is essential to regain elbow strength, range of motion, and stability. Physical therapy exercises are prescribed to optimise recovery.
It is important to consult with a healthcare professional to determine the most appropriate treatment approach based on individual factors, the severity of the injury, and patient goals. Early and proper treatment can significantly improve outcomes and help restore function to the elbow joint.
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