How is an elbow dislocation reduction? What do you need to know and can you do it yourself (e.g., dislocated elbow in a child)? IYThealth.com answers these and related questions.
A dislocation of the elbow joint is a displacement of the two main bones of the forearm from where they articulate with the humerus. Other specified bones can also come out of articulation in relation to each other. Elbow joint dislocation is often colloquially referred to as elbow dislocation, which has been shown to be the same name.
Causes of Elbow Dislocation
Most often, dislocations in traumatology are caused by injuries that happened in transportation, at home, and elsewhere. Less often, the doctor deals with the so-called habitual dislocation, when the force of the traumatic agent is small or may not be present at all, but the two bones in relation to the articular surface are unevenly positioned, indicating weakness of the ligament apparatus of the joint. Habitual dislocation of the elbow joint, which also occurs against the background of ligament weakness due to inflammatory processes, previous untreated dislocations for a long time, stretching of these anatomical formations, etc. is not excluded. Based on biomechanics, elbow dislocation can happen with a high degree of probability when a person falls on the outstretched arm, rather than from a blow to the area of the joint.
Elbow Dislocation Symptoms
Elbow dislocation has fairly typical signs, confirmed by instrumental diagnostic methods. The first thing that bothers the patient is pain, which does not subside and is intense. From the moment of application of force it does not become less, which distinguishes it from the pain of contusion, hemarthrosis and many other pathological conditions in traumatology. Immediately joins the swelling of the elbow joint. Elbow dislocation in the first hours never provokes an increase in local temperature, as well as redness, which should prompt the doctor to look for other diseases or existing comorbidities in the patient.
Due to the peculiarities of the anatomical structure, namely the proximity of the passage of the neurovascular bundle, there are clinical situations in which it is also injured due to dislocation. In this case the pulsation of the radial and ulnar arteries may be absent or impaired, which means impaired or complete cessation of blood flow through them. In this case, urgent hospitalization to a hospital with possible surgery is indicated. Of course, in this case the treatment of elbow dislocation is only operative, on vital indications. If a nerve is affected, the pain becomes intense and may irradiate to different parts of the shoulder.
Diagnosis
Diagnosis of elbow dislocation, as already said, is simple. Due to the available visual examination, experienced trauma physicians have no doubt about the diagnosis. However, in order to treat a dislocated elbow without any hidden nuances, a control radiograph is taken. Often, in addition to a dislocation, there is a fracture with displacement of bone fragments, etc.
Types of Reduction of Elbow Dislocation
First aid
Immediately after the injury you should put ice on it. Next you should check for nerve damage: check the pulse. To do this, alternately press on the nails on the hands. If the condition is normal, they will lighten, and after a couple of seconds they will return their pinkish hue. It is also necessary to check the nerve function. To check the radial nerve, bend the hand at the joint. To check the ulnar nerve, spread your fingers apart. To test the medial nerve, bring your thumb and little finger together. Check skin sensitivity. To do this, touch the area from your hand to your elbow.
Depending on the severity of the injury, the doctor prescribes conservative or surgical treatment for elbow dislocation.
Reyus Mammadli
Conservative method
Treatment of elbow dislocation is quite a complex process. After examinations, the doctor prescribes certain procedures. For starters, it is relocation, that is, reduction. The painful joint is returned to its usual place. Before this process begins, an anesthetic is administered to reduce pain. Pain management in traumatology involves not only creating a comfortable environment for the patient, but also a quiet operation for the surgeon. The patient’s muscles relax when the necessary threshold of anesthesia is reached, making the reduction procedure easy and effective. Treatment of elbow dislocation always requires certain conditions and individual approach to the patient; peculiarities of mental status sometimes require a careful conversation with the patient.
The method of reduction depends on the type of dislocation:
- A posterior dislocation is corrected by flexion (the joint is stretched and then flexed) or by “overextension” (the injured joint is flexed even more). The anterior dislocation is repositioned by bending the joint as much as possible and then pushing it back.
- After that, the injured joint is fixed to exclude the possibility of movement in it (a tight bandage or cast is applied). Further conservative method includes: different types of heating, physiotherapy, massage with various devices, including various types: direct and indirect.
Surgical method
With complications (damage to the ulnar nerve or fracture of the coronal process), the treatment of dislocation of the elbow joint is carried out only by surgery. The best chance of successfully reducing the dislocation is during the first 24 hours after the injury. Dislocations that are “over” a month old are always corrected promptly, and there are no guarantees of success.
An introductory video of how a dislocated elbow is fixed
Q&A
How do you reduce a dislocated elbow?
After the doctor has set the dislocated elbow, it must be left alone. To do this, a splint is used to hold the arm and in particular the elbow stationary. Normal medical practice indicates that this period usually lasts 10 to 20 days, according to AAOS. After that, the splint is removed under the supervision of a trauma surgeon and simple exercises are prescribed to restore the elbow’s motor function.
Should you reduce an elbow dislocation?
Absolutely. Elbow dislocation often leads to tears or damage to the ligaments of the elbow joint, nerve damage, can lead to inflammation and more serious consequences if the elbow is not reduced and the joint is restored.
Does a dislocated elbow require surgery?
Not necessarily. Simple dislocated elbows can be successfully repaired without surgery. However, if there is a fracture in the joint, surgery will be needed to return the arm (elbow) to full function, according to experts from the University of Washington. You need to understand that the goal of treatment is to get rid of the effects of the dislocation and restore function to the arm. The fracture may not heal properly, resulting in discomfort and even physical disability.
Is closed reduction a surgery?
No, it is not. It is a procedure performed by a surgeon/traumatologist under local anesthesia. The damaged bone is repositioned and a cast is applied after the surgeon is satisfied that the procedure was successful. No incisions and no blood.
Conclusion
As you can see, elbow reduction in a dislocated elbow is a complicated process that should ONLY be done by a doctor or trained person. If you need to learn how to fix a dislocated elbow, go to a medical school for the next steps. If you or someone near you has a dislocated elbow, see a doctor right away. You can only give first aid, as we wrote about above.
