Elbow Dislocation: Dangers of Self-Treatment, Professional Care, and Prevention

How to fix a dislocated elbow?

Attempting to fix a dislocated elbow yourself is extremely dangerous and can lead to severe, permanent damage. A dislocated elbow is a medical emergency that requires immediate professional medical attention for proper diagnosis, safe reduction, and comprehensive post-injury care.

Understanding Elbow Dislocation

An elbow dislocation occurs when the bones of the forearm (radius and ulna) are forced out of alignment with the bone of the upper arm (humerus) at the elbow joint. This is a significant injury that can involve damage to ligaments, tendons, nerves, and blood vessels.

• Anatomy of the Elbow Joint: The elbow is a hinge joint formed by the distal end of the humerus and the proximal ends of the ulna and radius. It is stabilized by strong ligaments, including the ulnar collateral ligament, radial collateral ligament, and annular ligament, which provide stability during movement. Dislocation typically involves tearing or stretching of these crucial ligaments.
• Common Causes: Elbow dislocations are often the result of high-impact trauma. Common causes include:
  • Falls onto an outstretched hand (FOOSH): This is the most frequent mechanism, where the force travels up the arm.
  • Direct blow to the elbow: Less common but can occur in contact sports.
  • Sports injuries: Especially in activities involving falls or high-speed collisions.

Why Self-Treatment is Dangerous and Ineffective

Attempting to "fix" or reduce a dislocated elbow without medical training and proper equipment is highly ill-advised and poses significant risks:

• Risk of Further Injury: Without a precise understanding of the anatomy and the specific direction of dislocation, untrained attempts can:
  • Damage Nerves: The ulnar, median, and radial nerves are vulnerable to stretching or crushing.
  • Damage Blood Vessels: Arteries and veins around the elbow can be torn, leading to severe bleeding or compromised blood flow to the forearm and hand.
  • Cause Fractures: Bones can be chipped, cracked, or completely broken during an improper manipulation.
  • Worsen Ligament Damage: Further tearing of the already compromised stabilizing ligaments.
• Complexity of Reduction: Proper reduction techniques require specific knowledge of biomechanics, the exact type of dislocation (e.g., posterior, anterior, divergent), and often, precise counter-traction and manipulation under controlled conditions.
• Pain Management: Reducing a dislocated elbow is extremely painful and often requires strong analgesia or sedation to relax the muscles and allow for successful manipulation without causing undue distress or muscle guarding.

Immediate Steps to Take After an Elbow Dislocation

If you or someone else experiences a suspected elbow dislocation, immediate and appropriate action is critical to minimize further harm and ensure the best possible outcome.

• Do Not Attempt to Reduce It: This is the most important rule. Resist any urge to pull, push, or twist the arm to try and put the joint back in place.
• Immobilize the Arm:
  • Support the arm in the most comfortable position possible.
  • Use a sling or improvise one with a scarf or piece of clothing to support the forearm and prevent movement.
  • Do not try to straighten or bend the arm if it causes significant pain or resistance.
• Apply Ice: Place an ice pack (wrapped in a cloth to prevent frostbite) on the elbow to help reduce swelling and pain. Do this for 15-20 minutes at a time.
• Seek Immediate Medical Attention: Go to the nearest emergency room or call for emergency medical services (e.g., 911 in the US) without delay. Inform them of the suspected dislocation.

Medical Treatment for Elbow Dislocation

Upon arrival at a medical facility, healthcare professionals will follow a structured approach to manage the injury:

• Diagnosis:
  • A thorough physical examination will be performed to assess the extent of the injury, check for nerve and blood vessel damage, and evaluate the type of dislocation.
  • X-rays will be taken to confirm the dislocation, rule out associated fractures, and determine the exact position of the bones. In some cases, a CT scan might be used for more detailed imaging.
• Reduction (Relocation):
  • Once diagnosed, the elbow will be "reduced" or put back into place. This procedure is typically performed under conscious sedation or general anesthesia to ensure muscle relaxation and minimize pain.
  • The physician will use specific, controlled maneuvers to gently guide the bones back into their proper alignment.
  • Post-reduction X-rays will be taken to confirm successful reduction and ensure no new fractures occurred during the process.
• Post-Reduction Care:
  • The arm will be immobilized in a splint or brace, usually at a 90-degree angle, for a period determined by the severity of the injury and associated ligament damage (typically 1-3 weeks). Prolonged immobilization is generally avoided to prevent stiffness.
  • Pain management will be prescribed.
• Rehabilitation:
  • Once initial immobilization is complete, physical therapy is crucial. A structured rehabilitation program will focus on:
    • Restoring Range of Motion: Gentle, progressive exercises to regain full elbow flexion and extension.
    • Strengthening: Exercises to rebuild strength in the muscles surrounding the elbow and shoulder, including the biceps, triceps, and forearm muscles.
    • Proprioception and Stability: Exercises to improve joint awareness and dynamic stability, reducing the risk of re-dislocation.

Preventing Future Elbow Dislocations

While not all dislocations are preventable, especially those from high-impact trauma, certain measures can reduce the risk of re-injury or initial dislocation:

• Strengthening Supporting Muscles: Consistent strength training for the muscles of the shoulder, arm, and forearm can provide better dynamic stability to the elbow joint. Focus on compound movements and isolated elbow flexion/extension.
• Improving Proprioception and Balance: Exercises that challenge balance and joint awareness can improve reaction time and control, potentially preventing falls or awkward landings.
• Proper Technique in Sports/Activities: Learning and consistently applying correct form in sports and weightlifting can minimize undue stress on the elbow joint.
• Wearing Protective Gear: In contact sports or activities with a high risk of falls, appropriate elbow pads or protective gear can offer some impact absorption.
• Addressing Underlying Issues: If joint hypermobility or other predisposing factors are present, consult a specialist for tailored advice.

When to Consult a Specialist

Following an elbow dislocation, ongoing care may be necessary. You should consult an orthopedic specialist if:

• You experience persistent pain, swelling, or instability after the initial healing period.
• You have limited range of motion that doesn't improve with physical therapy.
• You experience recurrent dislocations.
• There's any concern about nerve or blood vessel damage.

In conclusion, an elbow dislocation is a serious injury that demands immediate and professional medical intervention. Never attempt to "fix" it yourself. Proper medical management and dedicated rehabilitation are essential for a successful recovery and to minimize the risk of long-term complications.