The Assessment and Management of Simple Elbow Dislocations

Abstract

Background: Simple elbow dislocations are a commonly seen joint dislocation involving a sequential disruption of the soft tissue stabilisers without a significant associated fracture.

Methods: A selective literature search was performed and personal surgical experiences are reported.

Results: The majority of these injuries can be treated with expedient closed reduction, with the intact bony congruency of the elbow joint conferring early stability. Early mobilisation after reduction results in a faster recovery with good functional outcomes. Surgical intervention for persistent instability or stiffness is uncommonly required. Although, early surgical ligamentous repair has been considered, the current evidence does not demonstrate any long-term benefits compared to non-operative treatment.

Conclusion: The majority of simple elbow dislocations can be successfully managed non-operatively with good reliable outcomes. Careful follow up is essential, however, to identify patients that may occasionally develop persistent instability or stiffness and require intervention.

Keywords: Elbow Dislocations; Elbow joint; Epidemiology; Fracture; Simple Dislocation; Surgical intervention.

Fig. (1)

Antero-posterior and lateral radiographs showing postero-lateral simple elbow dislocation.

Fig. (2)

Antero-posterior and lateral radiographs showing postero-lateral simple elbow dislocation.

Fig. (3)

Antero-posterior and lateral radiographs after closed reduction of a simple elbow dislocation – note medial epicondyle avulsion fracture.

Fig. (4)

Antero-posterior and lateral radiographs after closed reduction of a simple elbow dislocation – note medial epicondyle avulsion fracture.

Fig. (5)

Three-dimensional computed tomography scan showing medial epicondyle avulsion following reduction of a simple elbow dislocation (this has ruled out any significant osseous injuries).