Elbow dislocation - Revision history

Rossdonaldson1: /* Evaluation */

2019-10-22T21:08:58Z

Evaluation

← Older revision		Revision as of 21:08, 22 October 2019
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	==Evaluation==		==Evaluation==
	[[File:Elbow dislocation lateral.jpg\|thumb\|Lateral view]]		[[File:Elbow dislocation lateral.jpg\|thumb\|Lateral view of posterior dislocation]]
	[[File:Elbow dislocation AP.jpg\|thumb\|AP view]]		[[File:Elbow dislocation AP.jpg\|thumb\|AP view of posterior dislocation]]
	*Imaging		*Imaging
	**Look for associated fractures (especially of coronoid and radial head)		**Look for associated fractures (especially of coronoid and radial head)
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	**[[Compartment syndrome]]		**[[Compartment syndrome]]
	**Neurovascular injury		**Neurovascular injury
	**Open dislocations		**Open dislocations

	==Management==		==Management==

Ekaduke12: /* Management */

2019-09-30T15:14:06Z

Management

← Older revision		Revision as of 15:14, 30 September 2019
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	*90% are posterolateral		*90% are posterolateral
	*Median and ulnar nerves may be injured		*Median and ulnar nerves may be injured
			*Brachial artery may be injured
	*"Terrible Triad" injury describes unstable joint consisting of:		*"Terrible Triad" injury describes unstable joint consisting of:
	*#Elbow dislocation		*#Elbow dislocation
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	==Management==		==Management==
	*Likely requires [[procedural sedation]]		*Likely requires [[procedural sedation]] and/or intra-articular analgesic injection
	*Reduction techniques: <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*Reduction techniques: <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	**~~Longitudinal traction on wrist/forearm with downward pressure on forearm~~		**To reduce dislocation:
	**~~Patient lies prone~~		***an assistant should stabilize the humerus in 30 degrees of flexion, supinated and apply countertraction
	***~~Assistant pulls counter~~ traction ~~on humerus~~		***provider applies traction to the supinated distal forearm
	***~~Provider pulls longitudinally~~ with ~~elbow~~ in ~~extension, then flexes elbow~~		***following reduction, patients should be immobilized in a posterior splint with orthopedic follow-up in 1 week
	**Stimson		**Stimson
	***Patient prone with elbow flexed at 90 degrees at edge of bed. Hang weight from hand, and if needed provider can push olecranon into place		***Patient prone with elbow flexed at 90 degrees at edge of bed. Hang weight from hand, and if needed provider can push olecranon into place

Rossdonaldson1: /* Management */

2019-05-17T07:32:12Z

Management

← Older revision		Revision as of 07:32, 17 May 2019
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	==Management==		==Management==
	*Likely ~~require~~ [[~~Procedural~~ sedation]]		*Likely requires [[procedural sedation]]
	*Reduction techniques: <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*Reduction techniques: <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	**Longitudinal traction on wrist/forearm with downward pressure on forearm		**Longitudinal traction on wrist/forearm with downward pressure on forearm

Mholtz: Text replacement - "==References== " to "==References== "

2017-07-13T15:46:08Z

Text replacement - "==References== " to "==References== <references/> "

← Older revision		Revision as of 15:46, 13 July 2017
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	==References==		==References==
			<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Rossdonaldson1 at 13:17, 27 April 2017

2017-04-27T13:17:54Z

← Older revision		Revision as of 13:17, 27 April 2017
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	*Median and ulnar nerves may be injured		*Median and ulnar nerves may be injured
	*"Terrible Triad" injury describes unstable joint consisting of:		*"Terrible Triad" injury describes unstable joint consisting of:
	**Elbow dislocation		*#Elbow dislocation
	**[[Radial head fracture]]		*#[[Radial head fracture]]
	**Coronoid fracture		*#Coronoid fracture

	==Clinical Features==		==Clinical Features==
	*Posterior dislocation
	**Elbow held in 45 degree of flexion; olecranon is prominent posteriorly
	*Anterior dislocation
	**Elbow held in extension
	*Swelling may be severe		*Swelling may be severe
	*Displaced equilateral triangle of olecranon and epicondyles (undisturbed in [[supracondylar fracture]])		*Displaced equilateral triangle of olecranon and epicondyles (undisturbed in [[supracondylar fracture]])

			===Posterior dislocation===
			*Elbow held in 45 degree of flexion
			*Olecranon is prominent posteriorly

			===Anterior dislocation===
			*Elbow held in extension

	==Differential Diagnosis==		==Differential Diagnosis==

Ted Fan: reduction techniques

2017-04-17T23:54:03Z

reduction techniques

← Older revision		Revision as of 23:54, 17 April 2017
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	==Clinical Features==		==Clinical Features==
	*Elbow held in 45 degree of flexion; olecranon is prominent posteriorly		*Posterior dislocation
			**Elbow held in 45 degree of flexion; olecranon is prominent posteriorly
			*Anterior dislocation
			**Elbow held in extension
	*Swelling may be severe		*Swelling may be severe
	*Displaced equilateral triangle of olecranon and epicondyles (undisturbed in [[supracondylar fracture]])		*Displaced equilateral triangle of olecranon and epicondyles (undisturbed in [[supracondylar fracture]])
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	**Lateral: both ulna and radius are displaced posteriorly		**Lateral: both ulna and radius are displaced posteriorly
	**AP: lateral or medial displacement with ulna/radius in their normal relationship		**AP: lateral or medial displacement with ulna/radius in their normal relationship
			*Red flags
			**[[Compartment syndrome]]
			**Neurovascular injury
			**Open dislocations

	==Management==		==Management==
	*~~Reduce via longitudinal~~ traction on wrist/forearm with downward pressure on forearm		*Likely require [[Procedural sedation]]
			*Reduction techniques: <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
			**Longitudinal traction on wrist/forearm with downward pressure on forearm
			**Patient lies prone
			***Assistant pulls counter traction on humerus
			***Provider pulls longitudinally with elbow in extension, then flexes elbow
			**Stimson
			***Patient prone with elbow flexed at 90 degrees at edge of bed. Hang weight from hand, and if needed provider can push olecranon into place
	*Immobilize in [[Long_Arm_Posterior_Splint\|long arm posterior mold]] with elbow in slightly less than 90deg flexion		*Immobilize in [[Long_Arm_Posterior_Splint\|long arm posterior mold]] with elbow in slightly less than 90deg flexion
			**If unstable, splint with forearm in pronation
			**Document post reduction neurovascular status and post reduction films

	==Disposition==		==Disposition==
	*Obtain emergent consult for irreducible dislocations, nerve or vascular compromise, associated fracture		*Obtain emergent consult for irreducible dislocations, nerve or vascular compromise, associated fracture, open dislocation
	*Simple dislocation requires ortho follow up within 1 week		*Simple dislocation requires ortho follow up within 1 week

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T18:26:45Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 18:26, 22 July 2016
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	{{Elbow DDX}}		{{Elbow DDX}}

	==~~Diagnosis~~==		==Evaluation==
	[[File:Elbow dislocation lateral.jpg\|thumb\|Lateral view]]		[[File:Elbow dislocation lateral.jpg\|thumb\|Lateral view]]
	[[File:Elbow dislocation AP.jpg\|thumb\|AP view]]		[[File:Elbow dislocation AP.jpg\|thumb\|AP view]]

Neil.m.young: Text replacement - "==Treatment==" to "==Management=="

2016-07-07T10:25:06Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 10:25, 7 July 2016
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	**AP: lateral or medial displacement with ulna/radius in their normal relationship		**AP: lateral or medial displacement with ulna/radius in their normal relationship

	==~~Treatment~~==		==Management==
	*Reduce via longitudinal traction on wrist/forearm with downward pressure on forearm		*Reduce via longitudinal traction on wrist/forearm with downward pressure on forearm
	*Immobilize in [[Long_Arm_Posterior_Splint\|long arm posterior mold]] with elbow in slightly less than 90deg flexion		*Immobilize in [[Long_Arm_Posterior_Splint\|long arm posterior mold]] with elbow in slightly less than 90deg flexion

Kxl328 at 18:54, 8 June 2016

2016-06-08T18:54:22Z

← Older revision		Revision as of 18:54, 8 June 2016
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	*Elbow held in 45 degree of flexion; olecranon is prominent posteriorly		*Elbow held in 45 degree of flexion; olecranon is prominent posteriorly
	*Swelling may be severe		*Swelling may be severe
			*Displaced equilateral triangle of olecranon and epicondyles (undisturbed in [[supracondylar fracture]])

	==Differential Diagnosis==		==Differential Diagnosis==

Ostermayer: Text replacement - "Category:Ortho" to "Category:Orthopedics"

2016-03-22T15:48:24Z

Text replacement - "Category:Ortho" to "Category:Orthopedics"

← Older revision		Revision as of 15:48, 22 March 2016
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	==References==		==References==

	[[Category:~~Ortho~~]]		[[Category:Orthopedics]]