Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Fractures and Dislocations

Dislocation

Dislocation of the elbow joint occurs mainly in athletes participating in contact sports, such as football, rugby, and ice hockey, but can also occur in riders, cyclists, wrestlers, skiers, and squash players. A
common cause of this injury is falling on the hand with a bent elbow. A similar injury can occur if the elbow is overstretched in a fall.
A backward (posterior) dislocation of the elbow joint is most commonly seen and may be combined with a fracture. Dislocations always involve injuries to surrounding soft tissues, such as the medial and lateral collateral ligaments, so that even when the injured joint is realigned promptly it can take some time for complete healing to take place.

Symptoms and diagnosis

– Intense pain, swelling, tenderness and limitation of mobility are experienced.
– There is deformity of the elbow joint.
– An X-ray confirms the diagnosis.
– Stability testing of the collateral ligaments at 20–30° flexion and in extension will show the extent of ligament injury.

Treatment

The doctor may
– after having checked nerve function and circulation, replace the joint to its normal position and test it for stability; the sooner this is done, the easier the manipulation;
– X-ray the joint after it has been restored to its correct position;
– immobilize the elbow joint in a brace for a few days depending on the extent of the injury. Mobility training should start as early as possible;
– operate if there are extensive ligament injuries and instability in the joint.

Healing and complications

When the brace has been removed, the injured athlete can resume conditioning exercises such as running. The athlete’s usual sport should not be resumed until 9–10 weeks after the occurrence of the injury, when the ligaments have healed and full mobility is restored.

Nerve and circulatory injuries may occur and give permanent symptoms in the forearm and hand. If a dislocated elbow is treated inadequately, the result may be incomplete healing of the ligaments and joint
capsule, and a susceptibility to recurrent dislocation.

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