Elbow dislocation: Difference between revisions

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*"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



Revision as of 11:27, 17 November 2015

Background

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

Clinical Features

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

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

Diagnosis

Lateral view
AP view
  • Imaging
    • Look for associated fractures (especially of coronoid and radial head)
    • Lateral: both ulna and radius are displaced posteriorly
    • AP: lateral or medial displacement with 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, nerve or vascular compromise, associated fracture
  • Simple dislocation requires ortho follow up within 1 week

See Also

References