41. Elbow dislocation

Essay 41- Dislocation of the elbow joint

• Elbow joint structure
• The bones that articulate are the humerus, radius and ulna
• There is one main movement it performs (flexion and extension)
• Dislocation of this joint can refer to:
• Both bones of the forearm are simultaneously luxated towards the humerus bone
• Isolated radial and ulnar luxation

• Mechanisms of dislocation
• Extension- most common
• Flexion
• Types of luxations
• Posterior- most common
• Anterior- very rare
• Medial
• Lateral
• Divergent
• Etiology
• Indirect lever-like- fall over palm in extended elbow joint!
• This force causes rupture of ligaments and articular capsule
• Olecranon protrudes backwards and its place is taken by coronoid process together with the radius
• Symptoms
• Elbow joint deformed
• Enlarged anterior-posterior size
• Olecranon protrudes and pit is formed above it
• Forearm is fixed in position (120-130 degrees)
• All motion is absent
• Pain
• Edema
• Bruising
• Functiolysis
• Diagnosis
• X-ray confirms the diagnosis
• Treatment
• Reduction under general anesthesia!
• 3 weeks immobilisation after reduction
• Flexion method
• Physician holds the joint so that the thumbs of their both hands are placed over the olecranon and the other fingers - over the forearm
• Elbow is flexed and the olecranon is pressed anteriorly with the physician's thumbs
• This repositions the joint into its place and a cracking is felt!
• A sleeve plaster cast is placed for 3 weeks!

• Complications
• Olecranon fracture
• Radial column fracture