Sports injuries and rehab: Elbow dislocations

What is an Elbow Dislocation?

The elbow is a hinge joint, or a ball and socket joint, that is made up of three bones that come together. The first bone is in the upper arm and is called the humerus. The other two bones are in the lower arm and are known as the ulna and the radius. The hinge joint allows the elbow to straighten and bend and the ball and socket joint allows it to rotate.

An elbow dislocation occurs when the area where these three bones meet, becomes disjointed or out of joint. The injury can affect either, or both, the hinge joint and the ball and socket joint motions. Dislocations in the elbow can be partial or complete. A partial dislocation occurs when the joint is only partly disconnected and a complete dislocation occurs when the joint becomes completely disconnected.

Elbow dislocations are categorized as either simple or complex. In a simple dislocation there is no major injury to any of the bones. In a complex dislocation there can be injury to the bones, tendons, and ligaments. Dislocations are also classified based on the direction that the forearm bones were facing when the dislocation occurred. Classifications for elbow dislocations are as follows:

Posterior: the radius and ulna (forearm bones) go behind the humerus (arm bone).

Anterior: the radius and ulna go in front of the humerus.

Medial: the radius and ulna go inward in relation to the humerus.

Lateral: the radius and ulna go outward in relation to the humerus.

Divergent: the radius and ulna move in opposite directions in relation to the humerus.

What Causes Elbow Dislocations?

Although elbow dislocations do not occur frequently, the most common cause of any injury to the elbow is a fall on the hands or wrists with the elbow in an extended position. When a hand hits the ground in this position all of the intensity is forced to the elbow. The force of the fall usually involves a rotating motion as well and this can cause the elbow to be pulled out of its socket. No one, single sport causes elbow dislocations, but any sport in which there is a risk of falling on the hands as described earlier, increases the likelihood of an elbow dislocation injury. Sports that might put an athlete at risk include gymnastics, skateboarding, rollerblading, hockey, bicycling, football, and basketball.

What are the Symptoms of an Elbow Dislocation?

The most common symptoms are pain, swelling, and an inability to move the elbow. Complete elbow dislocations are very painful. The elbow will become swollen and red and may look misshapen. It can look as though it is deformed due to abnormal twists in the elbow. There is usually pain when trying to move the elbow or bend the arm. A partial dislocation is harder to diagnosis because the bones can move back into place and appear normal on the outside. In a partial dislocation the elbow is movable but pain is still present. There can be bruising on the inside and outside of the elbow with both a complete and a partial dislocation. If there is severe pain or a loss of feeling in the hands, there could also be damage to the arteries and nerves that run along the elbow.

Treatment Options for an Elbow Dislocation

The main objectives in treating a dislocated elbow are to realign the elbow to its proper position and to retain normal functioning of the arm. Because elbow dislocations are considered an emergency injury treatment will often be provided in an emergency room setting. Once in the emergency room a patient will usually be given pain medications, x-rays will be taken to determine the extent of damage, and the elbow will then be reset. If the dislocation is a simple one further treatment will include immobilizing the arm by placing it in a splint for two to three weeks, followed up with physical therapy to regain full range of motion in the arm.

In the case of a complex dislocation surgery may be needed to realign and bone and to repair any damaged nerves, arteries, tendons, and ligaments. Once a patient has healed from surgery physical therapy will be employed to regain full range of motion in the arm. There is an increased risk, with a complex dislocation, of arthritis in the injured arm.

As a nationally certified Medical Assistant, I have had the opportunity to work in several different fields of medicine including sports medicine. Elbow dislocations are not as common as other sports injuries and usually require longer periods of physical therapy in order for the joints and bones to heal properly and to regain full use of the arm again.