Your elbow is a hinged joint made up of 3 bones: your upper arm bone (humerus) and the two bones in your forearm (ulna and radius). Muscles, ligaments, and tendons hold the elbow joint together, to form the joint capsule- a fluid filled sac that surrounds and lubricates the joint.
The muscles in your forearm cross the elbow and attach to the humerus. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle, while the bump on the inside of your arm is called the medial epicondyle.
The important ligaments of the elbow consist of the medial collateral ligament (on the inside of the elbow) and the lateral collateral ligament (on the outside of the elbow). These ligaments work together to stabilise the elbow, holding the humerus, radius and ulna tightly together. Another ligament called the annular ligament holds the radial head tightly against the ulna.
The tendons in your elbow attach muscle to bone. The biceps tendon attaches the biceps muscle on the front of your arm, and the triceps tendon attaches the triceps muscle to the back of your arm.
The arm consists of nerves that travel down and move across the elbow. There are three main nerves: the radial nerve, the ulnar nerve and the medial nerve. These nerves are responsible for controlling your muscles and sensations, such as touch, pain and temperature.
WHAT IS AN ELBOW DISLOCATION?
A dislocated elbow occurs when any of the three bones in the elbow joint (the humerus, ulna and radius) become separated or knocked out of their normal positions. An elbow dislocation is extremely painful, as it causes damage to the surrounding ligaments, and may cause damage to the surrounding muscles, nerves and tendons.
An elbow dislocation can fall under 2 categories: luxation (total separation of the elbow joint) and subluxation (partial dislocation of the elbow joint). According to the extent of damage done by the dislocation, there are 3 types of dislocations:
- Simple dislocation
There is no major bone injury
- Complex dislocation
There are severe bone and ligament injuries
- Severe dislocation
There is injury to the blood vessels and nerves around the elbow
WHAT ARE THE SYMPTOMS OF AN ELBOW DISLOCATION?
A dislocated elbow has the following symptoms:
- Bruising and swelling in the arm
- Deformity in the arm
- Weakness and loss of feeling in your hand
- Unable to move and bend the arm
- Extreme pain in the arm
WHAT ARE THE CAUSES AND RISK FACTORS OF AN ELBOW DISLOCATION?
Some causes of elbow dislocation include:
- Trying to stop a fall with an outstretched hand
- High impact blows to the elbow such as a motor vehicle accident
- Sports injuries
- Joint disorders such as Ehlers-Danlos syndrome where people have unusually loose and flexible joints
WHAT IS THE DIAGNOSIS OF AN ELBOW DISLOCATION?
A history of the injury and a physical examination of the elbow and arm will be conducted by the Doctor. He will check for any deformity and tenderness, and also check the wrist for a pulse. Nerve supply to the hand will also be checked in the case of nerve injury during dislocation.
Imaging tests will be taken, such as an x-ray for the doctor to examine the location of the dislocation. Rarely, a CT scan or an MRI scan may also be taken.
WHAT ARE THE TREATMENT OPTIONS FOR AN ELBOW DISLOCATION?
Typically, nonsurgical treatments are recommended for a simple dislocation.
- Wearing a sling to keep the elbow in place
- Reduction of the elbow to restore the alignment of the bones
- Physiotherapy to regain muscle strength and restore the range of motion of the elbow
- Medications for pain relief such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce pain and swelling
For a complex or severe dislocation, surgery may be required to repair the damaged ligaments, muscles and nerves, and restore bone alignment. Your elbow will be protected with an external hinge after surgery to help your elbow heal and prevent future dislocations.