Traumatic elbow dislocations

Abstract

Elbow dislocations occur mostly in the young adult population and nearly 50% occur during sporting activities. Diagnosis and assessment of concentric reduction following manipulation are performed using plain radiography and fluoroscopy. Computed Tomography (CT) enable identifying subtle fractures that can otherwise lead to chronic instability. Simple dislocations by definition have no associated fractures and complex dislocations are associated with a variety of fractures, with the terrible triad injury and trans-humeral dislocations leading to surgical challenges. Assessment of the direction and the mechanics of elbow dislocation enable identify the structures that have been injured. Posterior and posterolateral dislocations are the most common patterns, where the lateral ligament complex is often compromised. Most simple dislocations are amenable to reduction, immobilization, and gradual rehabilitation resulting in good functional outcome. Ongoing instability can occur in 10% of the patients. Complex dislocations pose a surgical challenge and lead to joint stiffness, pain and ongoing instability if not managed properly. Identifying the individual component of a complex dislocation such as radial head fractures, coronoid fractures, proximal ulnar fractures, and ligament injures is important for satisfactory outcome.