- Clinical science
The elbow is the second most commonly dislocated joint after the shoulder. A fall on an outstretched hand is the usual mode of injury. Complex elbow dislocations have an associated fracture, while simple elbow dislocations do not. Clinical features include pain and swelling of the joint and an inability to flex/extend the elbow. Examination reveals a loss of the triangular orientation between the medial and lateral epicondyles of the humerus and the olecranon process of the ulna. X-rays of the elbow joint confirm a dislocation and may show a positive fat pad sign. Simple elbow dislocations can be managed conservatively with closed reduction and immobilization. Complex elbow dislocations require surgical intervention with open reduction and internal fixation. Complications of elbow dislocation include joint instability/contractures and heterotopic ossification.
is discussed in another learning card.
- Trauma: typically from a fall with an outstretched hand
- Signs of fracture
- Neurovascular deficits
X-ray of the elbow joint
- AP view and lateral view to confirm dislocation and exclude fracture
- Radiocapitellar line: on a lateral x-ray of the elbow joint, an imaginary line drawn through the center of the neck of the radius should pass through the center of the capitellum of the humerus. If an elbow dislocation is present, the line does not intersect the capitellum.
- CT scan of the elbow joint: indicated to evaluate the extent of associated fractures
- Conservative management
- Surgical intervention
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We list the most important complications. The selection is not exhaustive.