Difference between revisions of "Elbow dislocation"

(Created page with "==Background== *Usually due to FOOSH *Posterior dislocation most common *Median and ulnar nerves may be injured ==Diagnosis== *Examine xray for associated fx (esp medial epicond...")
 
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==Background==
 
==Background==
 
*Usually due to FOOSH
 
*Usually due to FOOSH
*Posterior dislocation most common
+
*90% are posterolateral
 
*Median and ulnar nerves may be injured
 
*Median and ulnar nerves may be injured
 +
*"Terrible Triad" injury describes unstable joint consisting of:
 +
**Elbow dislocation
 +
**Radial head fracture
 +
**Coronoid fracture
  
==Diagnosis==
+
==Clinical Features==
*Examine xray for associated fx (esp medial epicondyle and radial neck)
+
*Elbow held in 45 degree of flexion; olecranon is prominent posteriorly
 +
*Swelling may be severe
 +
 
 +
==Diangosis==
 +
*Imaging
 +
**Look for associated fractures (esp of coronoid and radial head)
 +
**Lateral: both ulna and radius are displaced posteriorly
 +
**AP: lateral or medial displacement w/ ulna/radius in their normal relationship
  
 
==Treatment==
 
==Treatment==
*Reduce
+
*Reduce via longitudinal traction on wrist/forearm w/ downward pressure on forearm
*Immobilize in posterior mold
+
*Immobilize in long arm posterior mold w/ elbow in slightly less than 90deg flexion
  
 
==Disposition==
 
==Disposition==
*Ortho f/u within 1 week
+
*Obtain emergent consult for irreducible dislocations, NV compromise, associated fx
 +
*Simple dislocation requires ortho f/u within 1 week
 +
 
 
==See Also==
 
==See Also==
  

Revision as of 08:09, 8 February 2012

Background

  • Usually due to FOOSH
  • 90% are posterolateral
  • Median and ulnar nerves may be injured
  • "Terrible Triad" injury describes unstable joint consisting of:
    • Elbow dislocation
    • Radial head fracture
    • Coronoid fracture

Clinical Features

  • Elbow held in 45 degree of flexion; olecranon is prominent posteriorly
  • Swelling may be severe

Diangosis

  • Imaging
    • Look for associated fractures (esp of coronoid and radial head)
    • Lateral: both ulna and radius are displaced posteriorly
    • AP: lateral or medial displacement w/ ulna/radius in their normal relationship

Treatment

  • Reduce via longitudinal traction on wrist/forearm w/ downward pressure on forearm
  • Immobilize in long arm posterior mold w/ elbow in slightly less than 90deg flexion

Disposition

  • Obtain emergent consult for irreducible dislocations, NV compromise, associated fx
  • Simple dislocation requires ortho f/u within 1 week

See Also

Source

Tintinalli