Anatomy
The elbow joint is formed by the humerus and one of the two forearm bones (ulna). The other forearm bone (radius) forms a joint with the ulna (species radioulnaris proximalis). Around the elbow joint is a joint capsule and several reinforcing ligaments.
Elbow joint:
A. Humerus
B. Capsula articularis
C. Epicondylus medialis
D. Lig. collaterale ulnare
E. Chorda obliqua
F. Ulna
G. Radius
H. Tendo m. bicipitis brachii
I. Lig. anulare radii
J. Lig. collaterale radiale
K. Epicondylus lateralis
Cause
A direct fall on an outstretched arm can lead to an elbow dislocation. In some cases, the elbow dislocation will be complicated by bone fractures or damage to vessels or nerves.(Raux S, Madelaine A. 2023)
Symptoms
Sudden onset of pain around the elbow and pain-induced restriction of arm movement after a heavy load (fall). Often there is visible deformity of the elbow.
Examination
Sudden onset of severe pain in the arm with restricted movement after a fall should always lead to urgent medical attention. Due to the risk of damage to blood vessels and nerves, seek emergency medical attention (possibly hospital). Due to the risk of damage to blood vessels and nerves, this should be specifically investigated in the acute stage. X-rays can show the joint damage and any bone fractures.
Treatment
In uncomplicated cases, the elbow dislocation can usually be repaired without surgery. If the dislocation is combined with a bone fracture, surgery is required in almost half of the cases (Lewallen L, et al. 2023). In some cases, a short period of bandaging is then recommended. If the joint damage is complicated by vascular or nerve damage, surgery is usually necessary.
Rehabilitation with movement exercises within the pain threshold should be started as soon as possible.
Rehabilitation, specific:
In uncomplicated cases without bone fractures, vascular or nerve damage, rehabilitation can begin shortly after the joint damage is resolved (and any bandages removed). If the joint damage has been complicated and may have required surgery, rehabilitation should be carried out in close co-operation with the doctors supervising the treatment.
Complications
In the vast majority of cases, fractures around the elbow heal without complications. A few may experience persistent stiffness or looseness of the elbow, calcification of the muscles around the elbow and damage to nerves and blood vessels.
