An elbow dislocation occurs when the radius and the ulna (forearm bones) are forcefully displaced from their alignment with the humerus (upper arm bone). This injury typically results from a fall onto an outstretched hand or a high-impact accident. Since the elbow joint is highly stable, a significant force is required, meaning soft tissues like ligaments are almost always damaged. This injury is a medical emergency that requires prompt professional attention to prevent long-term complications.
Recognizing the Defining Signs of Elbow Dislocation
The most immediate sign of an elbow dislocation is the onset of sudden, severe pain at the joint, making the arm unusable. Any attempt to bend or straighten the arm will be met with resistance and increased discomfort. A complete dislocation causes a visible deformity, making the elbow appear noticeably out of place or twisted at an unnatural angle.
The joint may also have an abnormal lump or depression, and swelling will begin rapidly in the surrounding area. You may also experience numbness, tingling, or weakness in the hand or fingers. These sensations are important because they indicate that nerves (such as the median or ulnar nerves) or blood vessels have been stretched or injured during the displacement.
What to Do Immediately After the Injury
If you suspect an elbow dislocation, seek emergency medical care immediately. While waiting for help, prioritize immobilizing the injured arm exactly in the position it was found. Moving the limb could worsen damage to the surrounding ligaments, nerves, or blood vessels.
A makeshift sling can be used to support the arm and keep it still, but do not manipulate the joint while applying it. You can manage swelling and pain by gently applying a cold pack or ice wrapped in a thin towel to the area. Keep the ice on for 10 to 20 minutes at a time to avoid skin injury.
You must refrain from attempting to move the elbow back into place, a procedure called reduction. An untrained attempt at reduction can cause catastrophic damage, including tearing the brachial artery or permanently damaging nerves. Only a trained medical professional should perform the reduction under appropriate pain management and sedation.
Why Urgent Medical Imaging is Necessary
Urgent medical imaging, starting with X-rays, is mandatory for any suspected elbow dislocation, even if the joint appears visibly displaced. X-rays confirm the direction and extent of the displacement and, more importantly, are used to rule out associated fractures. A simple dislocation involves only ligament damage, but nearly half of all elbow dislocations are complex, meaning they involve a fracture.
Dislocations frequently occur alongside fractures of the radial head or the coronoid process, which are parts of the forearm bones that stabilize the elbow. The combination of a dislocation with fractures of the radial head and coronoid process is known as the “terrible triad” due to its high instability and poor prognosis. After initial X-rays, a computed tomography (CT) scan may be ordered to get a more detailed view of any complex bone fragments, which is essential for surgical planning.
Before and immediately after the joint is reduced, medical staff must perform a neurovascular assessment to check the health of the nerves and the pulse in the wrist. This check ensures that the brachial artery, which supplies blood to the forearm and hand, and the major nerves were not compromised by the injury or the subsequent movement. The ability to safely and effectively reduce the joint and prevent long-term disability hinges on this comprehensive imaging and examination.