Elbow Stabilisation After Dislocation Injury
Elbow dislocations can result in severe damage to the joint and surrounding structures, including the lateral ulnar collateral ligament (LUCL) complex, the radial head, and/or coronoid process. These injuries, when combined, are known as the "terrible triad" of the elbow. Elbow stabilisation surgery is often necessary to address these complex injuries and restore stability to the joint. On this page, we will explore the key aspects of elbow stabilisation surgery, including pre-surgical considerations, surgical treatments, and post-surgery rehabilitation.
Pre-surgical considerations
Before proceeding with elbow stabilisation surgery, several important factors are considered:
Comprehensive evaluation: The orthopaedic surgeon conducts a thorough evaluation of the elbow joint, assessing the extent of ligament and bone damage.
Imaging studies: X-rays, MRI, or CT scans are performed to obtain detailed images of the elbow joint, helping to plan the surgical approach.
Assessment of the terrible triad injury: If the terrible triad injury pattern is present (involving elbow dislocation, LUCL disruption, and fractures of the radial head and/or coronoid process), a more complex surgical approach may be required.
Surgical treatments
Elbow dislocation injuries may present with the following symptoms:
Elbow stabilisation surgery involves addressing the specific injuries and restoring stability to the joint. The following treatments may be considered:
LUCL repair or reconstruction: The lateral ulnar collateral ligament (LUCL) is evaluated, and in many cases, it can be repaired. However, in cases of severe injury, a reconstruction may be necessary, using tendon grafts to restore stability.
Radial head fracture treatment: If the radial head is fractured, it may be treated in two ways:
- Internal fixation: The radial head may be fixed using screws or a plate to secure it in place.
- Radial head replacement: In some cases, if the radial head is severely damaged, it may be completely replaced with a radial head prosthesis.
The device shown here is used for severe elbow dislocations where ligaments are severely damaged.Â
Post-surgery rehabilitation
Following elbow stabilisation surgery, rehabilitation is a crucial phase of the recovery process. Key elements of post-surgery rehab include:
Custom splint: Patients are often referred to an upper limb rehabilitation therapist who creates a custom thermoplastic splint to stabilise the elbow for the first 6 weeks after surgery. This splint helps protect the repaired or reconstructed structures and facilitates healing.
Range-of-motion exercises: After the initial period of immobilisation, patients begin gentle range-of-motion exercises to prevent stiffness and promote joint mobility.
Strengthening exercises: As healing progresses, progressive strengthening exercises are incorporated to restore elbow strength and stability.
Functional training: Specific activities and exercises are tailored to help patients regain functional use of their elbow joint and facilitate a safe return to daily activities.
Elbow stabilisation treatment with Dr Oscar Brumby-Rendell
Elbow stabilisation surgery is a complex procedure aimed at restoring stability and function to the joint after dislocation injury, especially in cases involving the terrible triad injury pattern. Pre-surgical evaluations, proper surgical treatments, and comprehensive post-surgery rehabilitation are vital for achieving successful outcomes. With advances in surgical techniques and post-surgery care, patients can expect improved elbow stability and enhanced joint function, allowing them to resume their daily activities with reduced pain and increased mobility.
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