"If an elbow dislocation is associated with a fracture (fracture-dislocation), it is called "complex." An isolated dislocation without fracture is "simple.""
"If an elbow dislocation is associated with a fracture (fracture-dislocation), it is called "complex." An isolated dislocation without fracture is "simple.""
"The most common associated fracture in adults is a radial head fracture, although coronoid process fracture is also common. When all of these occur together in a severe posterior dislocation, it is known as the terrible triad of the elbow 1-3. Other elbow fracture-dislocation patterns include the trans-olecranon fracture-dislocation and anteromedial coronoid fractures with associated varus posteromedial instability 6."
"In most cases, plain films suffice for assessment of elbow dislocations, although CT is increasingly used to pre-operatively assess intra-articular fractures."
"The dislocation is usually obvious, especially if adequate AP and lateral views are obtained, however, the challenge is in identifying associated fractures."
"Complex fracture-dislocations of the elbow require operative management, consisting of reduction of the dislocation, management of the fracture, and repair of surrounding damaged soft tissues (ORIF). They are far more likely to have a poor outcome, including secondary osteoarthritis, limited range of motion, instability (~40%), and recurrent dislocation as well as pain 1,5."
Expected headings
"Mechanism"
"Associations"
"Report checklist"
"Patients typically present complaining of a painful, swollen joint after a fall on an outstretched hand; also commonly occurs in the context of motor vehicle accidents, violence, and sporting events. In posterior dislocations, the affected elbow is commonly held in mid-flexion, whereas patients with anterior dislocations tend to adopt a position of forearm supination with extension at the elbow. Inspection may reveal a prominent olecranon posteriorly, and the ipsilateral forearm may appear "shortened" compared to the contralateral extremity. The range of motion will be decreased 7."
"After confirmation of stability through full range of motion and to applied varus and valgus stress a long arm posterior splint with the elbow at 90 degrees of flexion is typically placed; treatment goals in these patients may involve early physical therapy after a short course of immobilisation 1,3."
"Failure of closed reduction, or instability thereafter, mandates surgical management; the former is often due to the presence of soft tissue incarceration or the presence of osteochondral fragments 11."