An elbow dislocation is a severe injury where the bones of the forearm—the radius and the ulna—are forced out of their normal alignment with the upper arm bone, the humerus. This displacement results from significant trauma, such as a fall onto an outstretched hand, and immediately compromises the integrity and function of the joint. Recognizing the signs of this injury is the first step because a dislocated elbow requires immediate medical care to prevent complications.
Immediate Visible Signs of Displacement
The most telling sign of an elbow dislocation is the change in the shape of the joint. The normal contours of the elbow are replaced by a deformity that makes the joint look visibly “out of place” or misshapen. This is often accompanied by an unusual twist or angulation of the arm, which may appear shortened when compared to the uninjured limb.
The rapid onset of swelling is another indicator. Soft tissues around the joint, including ligaments and the joint capsule, are often torn or severely stretched during the displacement, leading to immediate inflammation and fluid buildup. This swelling can quickly obscure the underlying bony landmarks, making the joint appear puffy and enlarged.
Upon close inspection, there may be unusual lumps or depressions felt or seen around the joint where the bones have shifted. In posterior dislocations, the bony prominence of the ulna (the olecranon) may be pushed backward, creating a noticeable bulge behind the arm. Bruising may also develop rapidly from internal bleeding and soft tissue trauma.
Sensory and Functional Indicators
A person with a dislocated elbow will experience immediate, debilitating pain. This level of pain is far beyond a minor strain. The severity of the pain often makes any attempt at movement impossible.
A hallmark of a dislocated joint is the loss of function. The injured person will be unable to bend, straighten, or rotate the forearm, as the bones are no longer articulating correctly. The elbow is locked in a fixed position, and any attempt to move it is met with sharp resistance and pain.
Sensory changes in the hand or fingers can indicate potential complications involving the nerves that pass through the elbow joint. Numbness, tingling (often described as “pins and needles”), or a noticeable weakness suggests a possible injury to the median or ulnar nerve. Their function must be carefully assessed.
Essential Immediate Actions
If an elbow dislocation is suspected, seek emergency medical care without delay. Do not wait for the pain or swelling to subside, as prompt realignment, known as reduction, is necessary to minimize damage to nerves and blood vessels. The joint must be immobilized in the exact position it was found.
Use a sling, scarf, or makeshift splint to support the arm and prevent any movement of the joint during transport. Carefully apply ice packs to the outside of the joint to help manage the swelling. Always wrap the ice in a cloth or towel to avoid direct contact with the skin, which can cause tissue damage.
Never attempt to move the arm or force the joint back into place. This can severely damage surrounding ligaments, nerves, or blood vessels. Only a trained medical professional using proper sedation should attempt the reduction.
Call emergency services immediately if the arm or hand below the elbow turns pale, white, or blue, or feels cold to the touch. This change in color, temperature, or a complete lack of feeling indicates a serious compromise of blood flow or severe nerve damage. Checking for a pulse in the wrist is also a quick way to check for compromised blood flow.