Treatment of Unstable Simple Elbow Dislocations

Abstract

The elbow is the second most common joint dislocation in adults, with the shoulder being the most common. The annual incidence of elbow dislocation is 6.1/100,000. Elbow dislocations make up 10–25 % of all injuries to the elbow. Most elbow dislocations are stable after closed reduction, and treatment should consist of early range of motion. However, there is a small subset of simple elbow dislocations that are not stable after closed reduction and require operative treatment for stability and function. In an unstable simple elbow dislocation, the elbow joint is not congruent or subluxes after reduction, or requires more than a 45° extension block to maintain reduction. This is often due to interposed soft tissues or alternatively to ligamentous instability. Isolated elbow dislocation without any osseous lesions causes chronic instability in only 2 % of cases and is usually treated nonoperatively with early range of motion, while most fracture-dislocations require surgical treatment.