Elbow Dislocation

Hema N. Choudur, Anthony G. Ryan, Peter L. Munk

This patient presented to the emergency department with pain and swelling around the elbow with limitation of movement following a fall on an outstretched hand.

Figure 97A

Figure 97B

Posterior dislocation of the elbow.

• Radial head fracture
  
• Supracondylar fracture
  
• Medial epicondyle avulsion fracture and other fractures of the proximal forearm bones
  
• In children, nursemaid’s elbow

In adults, elbow dislocations are quite common, occurring second in frequency to shoulder dislocations. In children and adolescents, supracondylar fractures are more common. The inherently stable elbow joint requires a fair degree of force to cause dislocation; therefore, bony fractures accompany dislocations in a third of the patients. Posterior dislocations of the elbow are the predominant type and account for 80 to 90% of all elbow dislocations. However, anterior, lateral, or divergent dislocations can occur.

A fall on an outstretched hand with the elbow in extension results in posterior dislocation of the elbow. Coexisting shoulder, wrist, and distal radioulnar joint dislocations may occur.