Elbow dislocation
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