Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Elbow Dislocation in Emergency Medicine Follow-up

  • Author: James E Keany, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
 
Updated: Jan 21, 2016
 

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.[6]

Next

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
Previous
Next

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.

Previous
Next

Complications

Complications of elbow dislocation may include the following:

  • Brachial artery injury[7]
  • 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
Previous
Next

Prognosis

Up to 10 degrees limitation in full extension and some limitation in flexion are common, unless an intensive rehabilitation program is instituted.

Previous
Next

Patient Education

For patient education resources, see the Breaks, Fractures, and Dislocations Center, as well as Elbow Dislocation and Broken Elbow.

Previous
 
Contributor Information and Disclosures
Author

James E Keany, MD, FACEP Associate Medical Director, Emergency Services, Mission Hospital Regional Medical Center, Children's Hospital of Orange County at Mission

James E Keany, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, California Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Dekker McKeever, DPM Chief Podiatric Surgery Resident Physician, Trauma and Reconstruction Specialist, Mission Hospital Regional Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

David B Levy, DO, FAAEM Senior Consultant in Emergency Medicine, Waikato District Health Board, New Zealand; Associate Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine

David B Levy, DO, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, Fellowship of the Australasian College for Emergency Medicine, American Medical Informatics Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Joseph J Sachter, MD, FACEP Consulting Staff, Department of Emergency Medicine, Muhlenberg Regional Medical Center

Joseph J Sachter, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References
  1. Sheehan SE, Dyer GS, Sodickson AD, Patel KI, Khurana B. Traumatic Elbow Injuries: What the Orthopedic Surgeon Wants to Know. Radiographics. 2013 May. 33(3):869-888. [Medline].

  2. Murphy RF, Vuillermin C, Naqvi M, Miller PE, Bae DS, Shore B. Early Outcomes of Pediatric Elbow Dislocation-Risk Factors Associated With Morbidity. J Pediatr Orthop. 2015 Nov 3. [Medline].

  3. Modi CS, Wasserstein D, Mayne IP, Henry PD, Mahomed N, Veillette CJ. The frequency and risk factors for subsequent surgery after a simple elbow dislocation. Injury. 2015. 46 (6):1156-60. [Medline].

  4. Schreiber JJ, Potter HG, Warren RF, Hotchkiss RN, Daluiski A. Magnetic resonance imaging findings in acute elbow dislocation: insight into mechanism. J Hand Surg Am. 2014 Feb. 39 (2):199-205. [Medline].

  5. Reed MW, Reed DN. Acute ulnar nerve entrapment after closed reduction of a posterior fracture dislocation of the elbow: a case report. Pediatr Emerg Care. 2012 Jun. 28(6):570-2. [Medline].

  6. Anakwe RE, Middleton SD, Jenkins PJ, McQueen MM, Court-Brown CM. Patient-reported outcomes after simple dislocation of the elbow. J Bone Joint Surg Am. Jul 2011. 93(13):1220-26.

  7. Ayel JE, Bonnevialle N, Lafosse JM, Pidhorz L, Al Homsy M, Mansat P, et al. Acute elbow dislocation with arterial rupture. Analysis of nine cases. Orthop Traumatol Surg Res. 2009 Sep. 95(5):343-51. [Medline].

  8. Ali FM, Krishnan S, Farhan MJ. A case of ipsilateral shoulder and elbow dislocation: an easily missed injury. J Accid Emerg Med. 1998 May. 15(3):198. [Medline].

  9. Bell S, Salmon J. The management of common dislocations in the upper limb. Aust Fam Physician. 1996 Sep. 25(9):1413-5, 1418-23, 1425, passim. [Medline].

  10. Cohen MS, Hastings H. Acute elbow dislocation: evaluation and management. J Am Acad Orthop Surg. 1998 Jan-Feb. 6(1):15-23. [Medline].

  11. Gillingham BL, Wright JG. Convergent dislocation of the elbow. Clin Orthop Relat Res. 1997 Jul. (340):198-201. [Medline].

  12. Haddad FS, Cobiella CE. Isolated radial head dislocation in an adult: case report and review of the literature. J R Coll Surg Edinb. 1997 Jun. 42(3):207; author reply 208. [Medline].

  13. Hems TE. Isolated radial head dislocation in an adult: case report and review of the literature. J R Coll Surg Edinb. 1997 Jun. 42(3):207. [Medline].

  14. Kuhn MA, Ross G. Acute elbow dislocations. Orthop Clin North Am. 2008 Apr. 39(2):155-61, v. [Medline].

  15. Maxwell AJ. Isolated radial head dislocation in an adult: case report and review of the literature. J R Coll Surg Edinb. 1997 Jun. 42(3):207-8. [Medline].

  16. Noyez JF. Isolated traumatic posterior dislocation of the radial head: a report on two cases. Acta Orthop Belg. 1996 Sep. 62(3):148-50. [Medline].

  17. Rettig AC. Elbow, forearm and wrist injuries in the athlete. Sports Med. 1998 Feb. 25(2):115-30. [Medline].

  18. Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg Am. 1998 Apr. 80(4):566-80. [Medline].

  19. Sachar K, Mih AD. Congenital radial head dislocations. Hand Clin. 1998 Feb. 14(1):39-47. [Medline].

  20. Seijas R, Ares-Rodriguez O, Orellana A, Albareda D, Collado D, Llusa M. Terrible triad of the elbow. J Orthop Surg (Hong Kong). 2009 Dec. 17(3):335-9. [Medline]. [Full Text].

  21. Shearman CM, el-Khoury GY. Pitfalls in the radiologic evaluation of extremity trauma: Part I. The upper extremity. Am Fam Physician. 1998 Mar 1. 57(5):995-1002. [Medline].

  22. Sugimoto M, Yoshida T, Kitano K, Hosoya T, Tada K. Voluntary dislocation of the radial head. J Shoulder Elbow Surg. 1996 May-Jun. 5(3):228-30. [Medline].

Previous
Next
 
Anteroposterior radiograph of the elbow demonstrates the normal anatomy.
Lateral radiograph of the elbow demonstrates the normal anatomy.
Lateral view of the elbow demonstrates a posterior dislocation of the elbow. The patient also had a nondisplaced radial head fracture.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.