Elbow Dislocation in Emergency Medicine Follow-up
- Author: James E Keany, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH more...
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.
Further Inpatient Care
Indications for admission with frequent neurovascular assessment include the following:
- Unreliable patients
- Extensive edema
- Evidence of neurovascular compromise either before or after reduction
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 of elbow dislocation may include the following:
- Brachial artery injury
- 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
Up to 10 degrees limitation in full extension and some limitation in flexion are common, unless an intensive rehabilitation program is instituted.
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