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


Elbow Dislocation Treatment & Management

  • Author: Mark E Halstead, MD; Chief Editor: Craig C Young, MD  more...
Updated: May 26, 2016

Acute Phase

Rehabilitation Program

Physical Therapy

Early ROM exercises in stable, reduced elbow dislocations has been shown to be associated with an improved outcome. However, immobilization of the affected elbow for longer than 3 weeks in patients following an elbow dislocation has been associated with loss of ROM compared with patients who start early ROM exercises.[13]

A study by Iordens et al compared outcomes of early mobilization and plaster immobilization in patients with a simple elbow dislocation. The study found that patients in the early mobilization group recovered faster and returned to work earlier without increasing the complication rate.[16]

Medical Issues/Complications

Brachial artery disruption may be seen in any elbow dislocation and special attention should be made in open dislocations.

Ulnar nerve injury may occur in up to 15% of elbow dislocations. Perform an initial neurovascular assessment and frequent reassessments.

Median nerve injury is frequently seen in conjunction with brachial artery injuries because both of these structures are in close anatomic proximity. The median nerve function should always be assessed with a higher suspicion of injury if a brachial artery injury is known to exist. The median nerve may also be injured or entrapped during a reduction.

Associated fractures for elbow dislocation include those of the radial head or neck (5-10%), medial/lateral epicondyle avulsions (10%), those of the coronoid process (10%), and fractures of the distal radius, ulna, and proximal humerus (10%).

Compartment syndrome may develop in the forearm fascia or biceps tendon due to massive swelling, which may occur in an acute elbow dislocation. Compartment syndrome must be considered in the differential diagnosis in the presence of persistent patient pain, particularly when exacerbations of pain occur with passive finger and wrist extension of the dislocated arm.

Ectopic calcification, primarily around the collateral ligaments, is common after an elbow dislocation, provides no limitations and requires no intervention.

Myositis ossificans may also be seen if significant hemarthrosis developed with the elbow dislocation.

Surgical Intervention

Seek surgical intervention by an orthopedist if any signs of neurovascular compromise, associated fractures, or nonreducible dislocations are present.


Obtain orthopedic consultation if any signs of neurovascular compromise, associated fractures, or nonreducible dislocations are present.


Recovery Phase

Rehabilitation Program

Physical Therapy

Patients with limitations in ROM on follow-up evaluation may benefit from more aggressive physical therapy to regain loss of mobility.


Maintenance Phase

Rehabilitation Program

Physical Therapy

Depending on the severity of the elbow dislocation, it may take several months for the elbow to fully heal. Muscle-strengthening activities, in addition to the ROM program, are important to improve endurance of the elbow. Incorporate sport-specific training as the athlete progresses through rehabilitation to ensure a safe return to his/her sport.[17]

Surgical Intervention

Surgical intervention may be needed for a functional flexion contracture or for chronic residual instability.[18, 19, 20]

Contributor Information and Disclosures

Mark E Halstead, MD Associate Professor, Departments of Orthopedics and Pediatrics, Washington University School of Medicine; Team Physician, St Louis Rams, Washington University Athletics

Mark E Halstead, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.


David T Bernhardt, MD Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics/Ortho and Rehab, Division of Sports Medicine, University of Wisconsin School of Medicine and Public Health

David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine

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.

Henry T Goitz, MD Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Joseph P Garry, MD, FACSM, FAAFP Associate Professor, Department of Family Medicine and Community Health, University of Minnesota Medical School

Joseph P Garry, MD, FACSM, FAAFP is a member of the following medical societies: American Academy of Family Physicians, American Medical Society for Sports Medicine, Minnesota Medical Association, American College of Sports Medicine

Disclosure: Nothing to disclose.

  1. O'Driscoll SW. Elbow dislocations. Morrey BF, ed. The Elbow and Its Disorders. 3rd ed. Philadelphia, Pa: WB Saunders; 2000. 409-17.

  2. Rockwood CA Jr, Green DP, Bucholz RW, eds. Rockwood and Green's Fractures in Adults. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1996. 971-85.

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

  4. Ross G. Acute elbow dislocation: on-site treatment. Phys Sportsmed. Feb 1999. 27(2):121-2. [Medline]. [Full Text].

  5. Parsons BO, Ramsey ML. Acute elbow dislocations in athletes. Clin Sports Med. 2010 Oct. 29(4):599-609. [Medline].

  6. Sheps DM, Hildebrand KA, Boorman RS. Simple dislocations of the elbow: evaluation and treatment. Hand Clin. 2004 Nov. 20(4):389-404. [Medline].

  7. Carter SJ, Germann CA, Dacus AA, Sweeney TW, Perron AD. Orthopedic pitfalls in the ED: neurovascular injury associated with posterior elbow dislocations. Am J Emerg Med. 2010 Oct. 28(8):960-5. [Medline].

  8. Nelson AJ, Izzi JA, Green A, Weiss AP, Akelman E. Traumatic nerve injuries about the elbow. Orthop Clin North Am. 1999 Jan. 30(1):91-4. [Medline].

  9. Lee KS, Rosas HG, Craig JG. Musculoskeletal ultrasound: elbow imaging and procedures. Semin Musculoskelet Radiol. 2010 Sep. 14(4):449-60. [Medline].

  10. Mehta JA, Bain GI. Elbow dislocations in adults and children. Clin Sports Med. 2004 Oct. 23(4):609-27, ix. [Medline].

  11. Cohen MS, Hastings H 2nd. Acute elbow dislocation: evaluation and management. J Am Acad Orthop Surg. 1998 Jan-Feb. 6(1):15-23. [Medline].

  12. Ross G, McDevitt ER, Chronister R, Ove PN. Treatment of simple elbow dislocation using an immediate motion protocol. Am J Sports Med. 1999 May-Jun. 27(3):308-11. [Medline].

  13. Schippinger G, Seibert FJ, Steinböck J, Kucharczyk M. Management of simple elbow dislocations. Does the period of immobilization affect the eventual results?. Langenbecks Arch Surg. 1999 Jun. 384(3):294-7. [Medline].

  14. Villarin LA Jr, Belk KE, Freid R. Emergency department evaluation and treatment of elbow and forearm injuries. Emerg Med Clin North Am. 1999 Nov. 17(4):843-58, vi. [Medline].

  15. Macias CG, Bothner J, Wiebe R. A comparison of supination/flexion to hyperpronation in the reduction of radial head subluxations. Pediatrics. 1998 Jul. 102(1):e10. [Medline]. [Full Text].

  16. Iordens GI, Van Lieshout EM, Schep NW, De Haan J, Tuinebreijer WE, Eygendaal D, et al. Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial. Br J Sports Med. 2015 Jul 14 [Epub ahead of print]. [Medline].

  17. Duckworth AD, Kulijdian A, McKee MD, Ring D. Residual subluxation of the elbow after dislocation or fracture-dislocation: treatment with active elbow exercises and avoidance of varus stress. J Shoulder Elbow Surg. 2008 Mar-Apr. 17(2):276-80. [Medline].

  18. Micic I, Kim SY, Park IH, Kim PT, Jeon IH. Surgical management of unstable elbow dislocation without intra-articular fracture. Int Orthop. 2008 Aug 2. epub ahead of print. [Medline].

  19. Jeon IH, Kim SY, Kim PT. Primary ligament repair for elbow dislocation. Keio J Med. 2008 Jun. 57(2):99-104. [Medline]. [Full Text].

  20. Duckworth AD, Ring D, Kulijdian A, McKee MD. Unstable elbow dislocations. J Shoulder Elbow Surg. 2008 Mar-Apr. 17(2):281-6. [Medline].

  21. de Haan J, Schep NW, Zengerink I, van Buijtenen J, Tuinebreijer WE, den Hartog D. Dislocation of the elbow: a retrospective multicentre study of 86 patients. Open Orthop J. 2010 Feb 17. 4:76-9. [Medline]. [Full Text].

  22. Kesmezacar H, Sarikaya IA. The results of conservatively treated simple elbow dislocations. Acta Orthop Traumatol Turc. 2010. 44(3):199-205. [Medline].

  23. Burra G, Andrews JR. Acute shoulder and elbow dislocations in the athlete. Orthop Clin North Am. 2002 Jul. 33(3):479-95. [Medline].

  24. Englert C, Zellner J, Koller M, Nerlich M, Lenich A. Elbow Dislocations : A Review Ranging from Soft Tissue Injuries to Complex Elbow Fracture Dislocations. Adv Orthop. Epub 2013 Oct 21. [Medline].

  25. Sano S, Rokkaku T, Imai K, et al. Radial head dislocation with ulnar plastic deformation in children: An osteotomy within the middle third of the ulna. J Shoulder Elbow Surg. 2008 Jul 19. epub ahead of print. [Medline].

  26. 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].

  27. Bruinsma WE, Guitton T, Ring D. Radiographic loss of contact between radial head fracture fragments is moderately reliable. Clin Orthop Relat Res. 2014 Jul. 472(7):2113-9. [Medline]. [Full Text].

  28. Sormaala MJ, Sormaala A, Mattila VM, Koskinen SK. MDCT findings after elbow dislocation: a retrospective study of 140 patients. Skeletal Radiol. 2014 Apr. 43(4):507-12. [Medline].

Posterior and lateral dislocation of the left elbow in a soccer goalie. A small avulsion fracture of the olecranon is present.
The preferred method for posterior elbow dislocation reduction is to lay the patient prone with the humerus supported by the exam table. Place one hand around the wrist of the affected arm and apply downward traction, while the other hand stabilizes the humerus and the thumb is placed over the olecranon, with gentle pressure applied to facilitate reduction.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.