Elbow dislocation

Elbow dislocation is the second most common large joint dislocation in the adult population after shoulder luxation. In young children is commonly caused by puling child`s hand and it is called “nursemaid’s elbow” or “pulled-elbow syndrome”. Three bones come together to make up the elbow joint. Upper arm bone (humerus) and forearm bones (radius and ulna). Ligaments connected to the bones keep all of these bones in proper alignment. Dislocation happens when this bones are pulled apart. Several types of dislocations can occur in the elbow. Dislocations can be medial, lateral, posterior (most common) and anterior. It can also be complete (joint surfaces are completely separated - luxation), partial (joint surfaces are only partly separated -subluxation), simple (without any major bone injury), complex (with more serious bone and ligament injury), and severe (blood vessels and nerves that travel across the elbow are injured with the risk of losing arm). Considerable force is necessary to dislocate the elbow so sports activities account for up to 50% of elbow dislocations, and this type of injury is more commonly seen in young adult population. This force may occur following a direct impact (e.g. during contact sports), motor vehicle accident or more commonly due to a fall onto the outstretched arm. At risk are athletes like gymnasts, football players, wrestlers, rollerbladers, skateboarders, cheerleaders, rugby players, jumpers and weight lifters. Higher risk for elbow dislocation have people born with greater ligaments laxity, individuals with history of a previous elbow dislocation or those who haven`t had quality rehabilitation following a previous elbow dislocation. Symptoms, depending on the dislocation severity, include swelling, snapping sensation, redness, severe pain, weakness of the affected elbow (arm), loosing of feeling in hand, deformation of the elbow and bruising on inside and outside of the elbow. Injuries and dislocations to the elbow can affect elbow motions like flexion or extension (elbow bend and straighten) and rotation (palm up and down). Rehabilitation is essential in either surgical or non-surgical treatment of elbow dislocation to improve range of motion (flexion, extension, pronation and supination). One of the most important components of rehabilitation is rest and avoiding any activity that increases pain. Simple elbow dislocations are treated by keeping the elbow immobile for two to three weeks, followed by early motion exercises. While the arm is immobilized, patient can perform isometric exercises such as ball squeezes to keep the muscles active. Once the elbow's range of motion improves, patient can start with rehabilitation strengthening program that includes upper arm and forearm muscles. At the end sports-specific functional exercises can be started. Once the athlete has pain-free range of motion, full strength, and has completed sport-specific functional training, he may be released by physician to return to sports. Patients with complex dislocations can not perform any heavy lifting activities for at least six weeks to three months after surgery. During this period the primary focus is on regaining motion. This may take weeks to months to achieve an optimal outcome.