Elbow Dislocation

Anatomy
The elbow is inherently  a very stable joint because of the thick ligamentous structure surrounding the elbow and the architecture of the bony articulation.

Normal X-ray view of elbow

Etiology

The elbow joint is a very stable joint only a high energy injury is needed to dislocate it.

Typically tripping and fall or falling off a bicycle or motorcycle and landing with the arm in full extension.  
Mechanism of injury typical involve a fall form a bicycle

- loss of equilateral triangle

A 20-year-old male sustained a high energy injury in which he fell on outstretched hand and sustained the injury

shown in the radiograph below.

A. #5. What does this radiograph show? (2 marks)

 Dislocation of elbow (1 mark) OR

 Posterior dislocation of elbow (2 marks)

Called posterior because distal bone (ulnar is translated posteriorly.

B. #6. How would you like to further assess the elbow? (2 marks)

 Check for neurological deficit, i.e. ulnar nerve and posterior interosseous nerve assessment (1 mark)

 Check for vascular deficit, i.e. brachial and radial assessment (1 mark)

 Neurovascular status (1 mark)

 Open wounds (1 mark)

 Check for compartment syndrome (1 mark)

(1 mark each, any 2)

C. #7. What procedure/intervention would you perform for him if you see him in the emergency department? (2

marks)

 Closed manipulation (1 mark) and reduction (1 mark) (M&R) of the elbow

D. #8. What must you examine the patient upon successful completion of the intervention stated in (c)? (1 mark)

 Recheck NV status

E. #9. List (3) other fractures (not seen on this radiograph) commonly associated with this injury. (3 marks)

 Radial head/neck (1 mark)

 Coronoid (1 mark)

 Olecranon (1 mark)