Elbow dislocation

Revision as of 09:57, 10 October 2015 by Alvarez13 (talk | contribs)

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

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

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