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When the bones of the forearm, the radius and ulna, are disjointed or inappropriately connected to the bone of the upper arm, the humerus, an elbow dislocation occurs. Simply put, a dislocated elbow is the separation of the joint in the elbow.

Certain actions such as landing on an outstretched hand during a fall can misalign the bones, thereby causing dislocation of the elbow. An elbow has both hinge joints and a ball and socket joint, and bending and rotation are two types of motions that the elbow can perform. These two motions can be affected by dislocation of the elbow, the condition of a dislocated elbow in children is known as Nursemaid’s elbow, and toddlers often experience such condition when they swing their forearms. A dislocated elbow is the second most common dislocation experienced by the adults, following shoulder dislocation.

Symptoms

The symptoms of a dislocated elbow include the following:

• Extreme pain in the elbow
• Swelling in the elbow area
• Inability to bend the arm
• Distortion of the joint
• Bruising in case of partial dislocation
• If the arteries and nerves run by the elbow, your thumb will feel numb as well

Causes

The most common causes of a dislocated elbow in adults include the following:

• A fall with the arm stretched all the way out
• Traumatic injury like car accidents
• Rolling over an unusual way

In young children, causes include:

• Improper lifting and sudden pulling that can cause the arm to stretch outwards awkwardly
• Swinging a young child from the arms while playing. This can be prevented by avoiding lifting or swinging the child by the arms.

Treatment

In some cases, the dislocated elbow may slip back into the place on its own. However, in such cases too, a reduction procedure that allows for proper alignment of the dislocated elbow is necessary. The procedure is done by an orthopedist. A reduction procedure is painful, and medications to relieve pain are often prescribed. Once the dislocated elbow is manipulated back into place, the patient will need to wear splint or sling for a few weeks. It is vital to do physiotherapy exercises in order to improve the joints mobility and strength.

If the dislocated bones have been broken, other procedures such as reattachment of torn ligaments and repairing damaged nerves and blood vessels become necessary. A surgery may be required for recovery from such kind of a dislocation.

First Aid

Once a dislocation of the elbow occurs, do not change the position or try to straighten the dislocated arm. You can apply ice packs to the dislocated elbow. Avoid moving the affected elbow, shoulder, and wrist and consult a doctor immediately.

Rehabilitation of a Dislocated Elbow

A dislocated elbow can be a very painful condition. With appropriate rehabilitation, one can return to the normal condition with minimum recovery time. There are exercises that help to strengthen the bones and increase the mobility of the elbow. Also, once reduction has been done, an arm sling has to be worn for a few weeks. This prolonged immobilization of arm prevents recurring dislocation.

In order to succeed in returning normal activities of the patient with a dislocated elbow, the rehabilitation plan is essential. The rehabilitation for a posterior elbow dislocation has four phases.

• The first phase is the period when the elbow is immobilized.
• In the second phase, more vigorous therapeutic exercises are initiated. The goal of physical therapy is to restore normal motion and motor control. It includes the strengthening exercises. These exercises enhance the healing process.
• In phase three, normal functioning resumes. If the patient is an athlete, this is the period during which his/her normal practice and conditioning activities is resumed.
• Phase four is when complete rehabilitation is achieved and full activity is resumed.

Tips

• It is important to avoid further dislocation of the elbow during the healing process. So avoid activities such as carrying a heavy purse, lifting heavy bags, or pulling a heavy door. It is also vital to reduce activities during the acute phase in order to ensure faster recovery.
• In order to prevent recurrence of dislocation and re-injury, physiotherapy for a dislocated elbow is necessary. The physiotherapy treatment may include soft tissue massage, elbow taping, exercises to improve flexibility and strength, elbow bracing, joint mobilization, etc.
• Depending on the severity of the dislocation of the elbow, postoperative exercises are also prescribed. Biceps stretch is one of the exercises that target the biceps on the upper arm. During this exercise, muscles of shoulder, biceps, and upper chest are elongated. Arm curls are also used to strengthen biceps.
• Range of motion exercise is essential to increase and maintain the range of elbow. You can do it at home by flexing and extending your arm at the elbow. It can prevent joint freezing. Elbow strengthening exercises and elbow stretching exercises can strengthen your elbow joint muscles.
• You can apply ice packs on the injury to soothe pain. Anti-inflammatory medications can be used to reduce inflammation and speed up recovery.

References:

1. http://www.nlm.nih.gov/medlineplus/ency/article/000983.htm
2. http://www.umm.edu/ency/article/000983.htm

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