An elbow dislocation occurs when the bones that form the joint separate from their normal alignment. This joint is formed by the humerus, radius, and ulna. When these bones are forcibly displaced, the integrity of the joint capsule and surrounding ligaments is compromised. The elbow is one of the most frequently dislocated major joints, second only to the shoulder, often resulting from a fall onto an outstretched hand.
The Immediate Sensation of Dislocation
The onset of an elbow dislocation is marked by hearing or feeling a sudden “pop” or tearing sound. This mechanical event is immediately followed by intense, sharp, and debilitating pain localized directly within the elbow joint, frequently requiring immediate medical intervention.
The acute pain is caused by the stretching and tearing of the joint capsule, collateral ligaments, and surrounding soft tissues as the bones shift position. The intensity of the pain prevents any voluntary movement of the arm, which is an involuntary protective response.
Following the initial shock, the subjective feeling shifts to one of profound instability. The arm feels physically “out of place,” and any attempt to move the joint results in an excruciating spike of pain.
Visible Signs and Loss of Mobility
The internal sensation of displacement is quickly mirrored by observable changes in the elbow’s appearance. The most telling sign is the obvious deformity, where the normal triangular relationship of the bony landmarks is lost. The elbow may appear visibly twisted, unnaturally prominent, or shortened compared to the uninjured side.
Soft tissue damage causes significant swelling (edema), which begins almost immediately and progresses quickly. This inflammatory response further obscures the underlying bony structures. Bruising (ecchymosis) often develops shortly after the injury as blood leaks from damaged capillaries.
Functionally, the injury results in a near-complete loss of active and passive mobility. The individual is unable to bend or straighten the arm, and the limb is often held instinctively in a flexed position, cradled against the chest by the uninjured arm. This protective posture prevents further painful movement of the unstable joint.
Critical Indicators of Nerve or Vessel Involvement
While pain and deformity are expected, certain symptoms indicate a serious complication involving the surrounding neurovascular structures. The brachial artery, which supplies blood to the forearm and hand, runs close to the elbow joint and can be stretched or compressed by the displaced bones. Compromise of this artery is a time-sensitive medical emergency.
Signs of arterial damage include a noticeable change in hand color, which may become pale, white, or cyanotic (blue) due to lack of oxygenated blood flow. The hand and fingers may also feel colder than the uninjured side, and a pulse may be difficult or impossible to detect at the wrist. These circulatory changes demand immediate attention to prevent tissue death.
The dislocation can injure the nerves that pass through the elbow, particularly the ulnar and median nerves. Damage to these structures is signaled by sensory changes in the hand and fingers, such as numbness, a heavy feeling, or persistent tingling. These neurological indicators must be quickly assessed by medical professionals, as prolonged compression can lead to permanent nerve dysfunction.
Necessary Immediate Actions and Medical Triage
An elbow dislocation requires immediate emergency medical attention due to the potential for neurovascular injury. Contact emergency services or arrange transport to the nearest emergency department without delay. Time is a factor because soft tissue swelling begins rapidly, making the eventual medical procedure to reposition the bones more difficult.
While waiting for help, the injured arm must be stabilized exactly as it was found to prevent further damage. Support the elbow with a soft pillow or rolled-up towel and gently secure it with a sling or bandages, ensuring no pressure is placed directly on the joint. Lightly elevating the arm may help minimize swelling.
Never attempt to manipulate or force the joint back into its proper position. This practice, known as “reduction,” can cause catastrophic damage, including tearing ligaments, fracturing bones, or severing compromised nerves and blood vessels. Only trained medical personnel, often using sedation, should perform the reduction procedure.
The priority of medical triage is to assess the circulatory status and nerve function of the hand immediately upon arrival. This initial assessment guides the urgency of the treatment plan, ensuring blood flow compromise is addressed before focusing on pain management and joint repositioning.