[Medline]. A partial dislocation is referred to as a subluxation. Complicated dislocation (dislocation with associated fractures) or neurovascular compromise, because the procedure itself may increase injury severity. The most serious complication of joint reduction for posterior elbow dislocation is brachial artery injury. Ortop Traumatol Rehabil. If the tip of the olecranon seems anterior to the plane, the elbow is likely dislocated. For elbow dislocations, reduction is usually with sustained, gentle traction and correction of deformity after patients are sedated and given analgesics. 2007 Oct. 32 (8):1200-9. An associated neurovascular deficit warrants immediate reduction. Dr. Fakhouri of MidAmerica Orthopaedics and MidAmerica Hand To Shoulder Clinic demonstrates Posterior Elbow Dislocation & Reduction. Apply ice to your elbow for 15 to 20 minutes every hour or as directed. Gently move elbow through its range of motion. Angiography is needed if signs of arterial injury (eg, pallor, pain, cyanosis, soft tissue expansion [possible hematoma]) are present. [13]. Assess the following: Distal pulses, capillary refill, and temperature (for coolness, suggesting brachial artery injury), Light touch sensation of the thenar and hypothenar eminences (median and ulnar nerves), and dorsum of the 1st web space (radial nerve), Wrist flexion and pronation, thumb-index finger apposition ("OK" gesture), and finger flexion against resistance (median nerve), Finger abduction against resistance (ulnar nerve), Wrist and finger extension against resistance (radial nerve). Do a post-procedure neurovascular examination. Bono KT, Popp JE. They are far more likely to have a poor outcome, including secondary osteoarthritis, limited range of motion, instability (~4… 2018 Jun. Patients with significant soft tissue swelling, hematoma, or questionable vascular/neurologic integrity should be admitted for continuing observation, either to an emergency department observation unit or to a hospital. [14, 15] Check for signs of delayed vascular compromise after reduction. 2002 In the most severe elbow dislocations, the blood vessels and nerves that travel across the elbow may be injured. Place the patient prone, with the forearm dangling over the side of the stretcher. Clin Sports Med. This device protects the elbow from dislocating again. If the joint is not reduced, ask the assistant to lift the humerus while maintaining the downward pressure on the olecranon while you attempt to further flex the elbow. Supine approach, with addition of flexion and pressure against proximal volar surface of forearm. 2008 Feb. 24 (1):9-25. [Medline]. [] More than 90% of all elbow dislocations are posterior dislocations. Swab the area with antiseptic solution, and allow the antiseptic solution to dry for at least 1 minute. Apply steady downward traction to the forearm while maintaining flexion of the elbow. BMC Musculoskelet Disord. At home, put ice on the elbow. For simple elbow dislocations, the elbow should be reduced as soon as possible. If the elbow appears to subluxate or dislocate, put in a backslab with elbow flexed 90° and do check x- ray (AP / Lat). Definition/Description. Analysis of magnetic resonance imaging-confirmed soft tissue injury pattern in simple elbow dislocations. Reduction of the dislocated elbow is the major treatment of a dislocated elbow. no associated fracture) then closed reduction and a brief period (e.g. no associated fracture) then closed reduction and a brief period (e.g. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. (See also Overview of Dislocations and Elbow Dislocations.). 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