Elbow Dislocation in Emergency Medicine Follow-up
- Author: James E Keany, MD, FACEP; Chief Editor: Rick Kulkarni, MD more...
Further Inpatient Care
- Indications for admission with frequent neurovascular assessment include the following:
- Children
- Unreliable patients
- Extensive edema
- Evidence of neurovascular compromise either before or after reduction
Further Outpatient Care
- Following reduction, splint elbow in at least 90 degrees of flexion using a posterior molded splint.
- Arrange close follow-up care with the orthopedic surgeon. In a self-reported study of patients sustaining simple elbow dislocations, despite a good long-term functional prognosis, there was a relatively high rate of residual pain and elbow stiffness. Therefore, it is important for patients to receive timely outpatient follow-up with an orthopedic specialist.[2]
Transfer
- Patients with dislocations of the elbow should not be transferred until the elbow has been reduced.
- In hospitals without access to an orthopedic surgeon, reduction should be performed by the emergency physician prior to transfer.
Complications
Complications of elbow dislocation may include the following:
- Brachial artery injury[3]
- Medial nerve injury
- Ulnar nerve injury
- Concomitant fractures
- Avulsion of the triceps mechanism insertion (anterior dislocation only)
- Entrapment of bone fragments within the joint space
- Joint stiffness with decreased range of motion (particularly in extension)
- Myositis ossificans
- Compartment syndrome
Prognosis
- Up to 10 degrees limitation in full extension and some limitation in flexion are common, unless an intensive rehabilitation program is instituted.
Patient Education
- For patient education resources, see the Breaks, Fractures, and Dislocations Center, as well as Elbow Dislocation and Broken Elbow.
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