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What is a dislocated elbow?
An elbow dislocation happens when the bone in the upper arm separates from the two bones that form the lower arm (forearm). It can happen after trying to brace a fall with an outstretched hand or from the impact of a car accident. It’s the most common joint dislocation in children under 10 years old and is more common in teens and adults people under 25.
An elbow dislocation can be extremely painful. People sometimes feel or hear a pop when the elbow is injured. And sometimes you can break (fracture) one of the arm bones at the same time. You’ll need to go to the emergency room to get treated immediately.
How do I know if my elbow is dislocated?
An important question to ask your doctor: Will I need a surgical procedure to fix my elbow or will it heal with physical therapies alone? —Dr. Bradley Graw
An elbow dislocation causes severe pain around the elbow after a fall or accident. You may also hear or feel a “pop” in your elbow area. Your elbow may swell and there may be a bump. Your arm will hurt and it can be hard to move it without sharp pain.
- Severe pain at the elbow
- Swelling or noticeable bump or protrusion on the arm
- Unable to move your elbow
Other symptoms you may have
- Bruising on your skin
- Skin tear
- Forearm pain (if another bone is broken)
- Numbness or tingling in the hand
- Coolness in the extremity
Dislocated elbow causes
The elbow is composed of three arm bones that come together at the elbow to form three joints. Strong ligaments surround the elbow, keeping the joints in place during everyday movement. A dislocation occurs when one of the elbow joints moves out of place.
The most common type occurs when the two forearm bones (radius and ulna) are forced behind the upper arm bone (humerus). Sometimes, the same force causes one of the forearm bones to fracture in addition to the dislocation. When that happens, it’s called a complex elbow dislocation.
The elbow can be dislocated by overextending it or overflexing or twisting it. These motions lead to different types of dislocations that a doctor can help diagnose through a physical examination and imaging studies.
Dislocated elbow in children
Young children under 5 years old don’t need to fall to have an elbow dislocation. Although it’s rare, some kids under 5 can get a partial dislocation, or pulled elbow, just from rough play. They may even get a partial elbow dislocation while swinging from an adult’s hands.
This type of injury is called a “nursemaid’s elbow” and does not generally lead to any permanent deformity or disability.
If your child is complaining of pain and isn’t moving their arm, go to the ER. They’ll probably need an X-ray to determine the extent of the injury. If the injury is a partial elbow dislocation, a doctor will gently “pop” it back into place in a procedure called a reduction.
If your child repeatedly has the same injury, your doctor can teach you techniques to pop it into place at home. Never try to pop it into place without a doctor’s recommendation and instructions.
Treatment for dislocated elbow
Many people end up in the emergency room and require sedation to put the elbow back in place. This injury can really hurt! But manipulating the elbow back in place generally works well with no surgery needed. —Dr. Graw
If you have severe pain and swelling and can’t move the elbow, go to the emergency room. It needs to be treated right away. Keep your arm still (immobile) by holding the elbow close to the chest with the other hand or a sling if available.
While an elbow can pop back into place from moving your arm, you shouldn’t try to pop it back in yourself. Moving your arm may make the injury worse.
You will probably have an X-ray to confirm that it’s dislocated. A doctor will also check for any other bones in your arm. If there are no other broken bones, the doctor can gently push the joint back into place. You may be given pain or sedative medication to help with the discomfort during this procedure. It’s important to get this procedure within a few hours of the dislocation.
If you also have a broken bone, you may need a cast or surgery to repair the break or any torn ligaments. The surgery is usually done in an outpatient surgical center within the first days or a few weeks depending on the severity of the injury.
Eventually, elbows tend to get stiff after this type of injury. You may always have incomplete extension of the elbow by 5 to 10 degrees. —Dr. Graw
Depending on the injury and treatment, the elbow will need to be kept immobile for different amounts of time. If it’s a simple dislocation, you’ll probably be given a sling to wear for 1 to 2 weeks.
If you’ve had surgery, you may have a cast and the elbow will be immobilized with a sling or splint. At your post-surgical follow-up appointment, the splint may be changed for a hinged elbow brace. Wearing a sling or splint for too long can lead to elbow stiffness.
You will be evaluated after two weeks to check that surgical incisions have healed. You will have follow-up appointments to check that your joint stability, strength, and range of motion are improving.
When you can begin to move your elbow again, you may need physical therapy to improve the movement and range of motion in your elbow joint. Elbows have a tendency to get stiff even with physical therapy, so keep in mind that there may be some permanent stiffness or inability to extend the elbow completely.
Brad Graw, MD, is an orthopedic surgeon who specializes in reconstructive surgery of the hip and knee at Palo Alto Medical Foundation. Dr. Graw completed two fellowships at Stanford University for joint replacement surgery and Sports Medicine. He received his medical degree at Georgetown Medical School where he also completed residency. He received his MBA at the Wharton School at University of Pennsylvania.