Elbow Dislocation In Adults - Everything You Need To Know - Dr. Nabil Ebraheim
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- เผยแพร่เมื่อ 17 ธ.ค. 2018
- Dr. Ebraheim’s educational animated video describes the condition of elbow dislocation in adults.
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Elbow Dislocation in Adults
With elbow dislocations, recognize the terrible triad: elbow dislocation, radial head fracture, and coronoid fracture. The terrible triad is not a simple elbow dislocation; it is a complex elbow dislocation. In addition to these three injuries of the elbow, there is always a tear of the lateral ulnar collateral ligament. The treatment usually is reduction and splinting of the elbow. This cannot be the definitive treatment; it is the initial treatment. If no surgery is done, you will have recurrent dislocation of the elbow. You need to do surgery for reduction and fixation of the fractures and also to restore the elbow stability. This injury is unstable. Simple reduction and splinting is not going to work for this injury. You have to recognize the terrible triad which means surgery. There are multiple types of elbow dislocation based on the position of the olecranon relative to the humerus. The most common type of elbow dislocation is the posterolateral type. There are two basic types of elbow dislocations: simple and complex. Simple elbow dislocations have no fracture seen, and are usually a ligamentous injury. Complex elbow dislocations have associated fractures in addition to the ligamentous injury. With any elbow dislocation, you need to check the shoulder and the wrist for injuries and fractures because it can occur in up to 15%. When you have a simple dislocation of the elbow, you need to reduce it and then check the range of stability of the elbow. If you find that the elbow is stable with range of motion, then you will do a short period of immobilization with a posterior splint for approximately one week with the elbow in about 90 degrees of flexion. Then start active range of motion of the elbow. Recurrence of the dislocation is rare (less than 1%). If you keep the elbow immobilized more than 3 weeks, there will be severe stiffness of the elbow. Surgery should be done if the dislocation is irreducible, if there is associated fracture, or if you are unable to maintain stability of the elbow. After immobilization and early range of motion of the elbow, you will see the patient and do follow up x-rays to check joint congruity and to make sure that the elbow reduction is maintained. To treat the terrible triad, you should initially do a closed reduction. Open reduction and internal fixation of the coronoid (if possible), of the radial head or excise the radial head with radial head arthroplasty if the radial head is unreconstructable. In addition, you will do lateral ulnar collateral ligament (LUCL) repair. Never excise the radial head alone in this situation. For an elbow dislocation with olecranon fracture, do open reduction and plate fixation. K-wires and tension band is not strong enough to hold the fracture and stabilize the elbow at the same time. For an elbow dislocation with a radial head fracture, do fixation or replacement of the radial head (never do excision of the radial head alone in this situation). The LUCL is the most important lesion in recurrence or persistence of instability of the elbow following simple elbow dislocation. The injury progresses from lateral to medial. The lateral collateral ligament fails first, and it avulses proximally at the lateral epicondyle. The medial collateral ligament (MCL) fails last. In varus posteromedial rotary instability, there is an elbow injury plus LUCL tear, plus coronoid fracture which involves the medial facet of the coronoid. Treatment for chronic dislocation is open reduction capsular releases with hinge external fixation and early range of motion. Loss of terminal extension is a complication of elbow dislocation. Usually for decreased range of motion of the elbow, you will do static progressive splinting between 6-10 weeks. No manipulation of the elbow is done, which is different from the knee after total knee replacement, where you can do manipulation up to three months. With heterotopic ossification, do excision. Remove the myositis and excise the posterior part of the MCL to allow more flexion. To be functional, the range of motion of the elbow should be between 30-130 degrees. Some physicians suggest that if the flexion is less than 100, you will do release of the posterior bundle of the MCL in addition to release of the ulnar nerve. If you want more flexion of the elbow, excise the posterior part of the MCL.
super informative, clear and precise. good that you discussed complications and lots of tips
Doc, your videos really help greatly. Thanks a million!
Clear explanation and good presentation thanks a lot.
Very helpful
Thank you very much doctor
شكرا يا دكتور على الفيدوات الجميله
Thank you
I'm from Indonesia... Thanks for the video.. Its help fully
Helpful video
Thank you doc very interesting and helpful presentation. What is the kost common form of iniury? Landing with elbow bent and then rotation probation or supination or huperextension? Hyperlexion? Trauma to elbow?
Thank you 🙏🏻
It's a beautiful video
Pls can you show a video of distal humerus fracture ( with surgery 2 screws to fixate it ) and dislocation of elbow ( left arm ) as I had this injury and I am still trying to recover 6 months later ,,,, as cast was left on for 45 days. Thank you.
Thank you. It is helpful.
I love you
Doc, I got question, can it be possible to cure my dislocated elbow, even if it's 5 years ago
What about elbow dislocation with fracture of the lateral epicondyl? What is the treatment for that?
Thank
Sir my elbow is sounding 2 Years ago elbow dislocation in accident please reply
Where do I go if I had a lateral dislocated elbow for more than 20 years ? I have tried to get surgery, but no one can do it.
How can i make an appointment for this type of treatment at your hospital? Am in maryland state
Looking at just a simulation of this looks painful. Thank you though, very informative and easily explained.
Trust me, it is. Dislocated my elbow a few moths back
After that breaking my arm feels like stubbing my toe.
I’ve broken 3 arms but would rather break them all again than dislocate my elbow once
Unbelievable pain!!!!
Very painful. Had this and broke the arm
oh it is
Why the elbow is immobilized in flexion following posterior dislocation reduction?
thxx sir it is helpful
My elbow joints dislocated wen i was 6 years old now im 32 years old now..is there a possibility to fix it? I have simple dislocation based on your discussion
Doc.. How about.. 2months dislocation of the elbow... Can it be fixed?
Sir my right elbow lucl fracture since 15 yeras ago looking dislocation pls advice me as soon as possible
On my right arm on the side of my elbow theres a bone i can feel pop in and out when i trie to bend my arm in a certian way for example flexing my biceps but it doesnt really hurt?
Sitting in a splint currently, makes my arm tingle watching this💀
How much surgery
Only your channel discuss the topic more clinically
I have bad dislocation elbow 10 years ago..what should I do..pls reply
My right elbow dislocated when I fell down from my motorcycle, I was 15 I'm 24 right now, but this year was causing me some pain and tiredness, is there any solution for it to fix it without breaking it? :(
I can move my arm in almost every way, sometimes if I move it in a different way I hear something cracked up in my elbow but it's not hurting, and I cannot rotate my arm 100% (like when we rotate our arm to see our veins for example if you know what I mean)
same man 5 years with a dislocated elbow here. heard it was a calcification or something in my elbow cant staighten my elbow completely and lately its been paining a lot in elbow area
same here, from the Philippines,my elbow dislocated 10 years ago,can it be possible to fix?
@@Iloco28 As a PT student, I suggest you guys try to seek professional help. Doctors may also suggest Xrays or MRI (expensive) to see the structural integrity of your elbow.
If your problems are determined, its either you get surgery or methods that are conservative such as physical therapy, elbow stabilizers etc. :)
@Pradyumansingh_🦅 me too
How much make hand problem
doc,can i need your contact for discuse about my elbow injury
Doc, can I need your contact for discuss my problem
Sir what is the reason of flexion of elbow at posterior dislocation??
Thats what i have right now. Im at an urgent care right now and they cant help me on sunday because the xray person isnt here today.
I'm here cuz the jamahal vs Craig fight
How do i fix my elbow then it hurts
how much sir
How to differentiate a terrible triad from a simple dislocation
What happens when there is still pain when you are exerciseing it
My 2 yr old sister just had a simple elbow dislocation and is getting surgery rn
I've been get this since january 2021, but i didn't go to hospital to get any treatment instead i'm just let it be i thought it will be okay, but after 1 years it didn't going well, my elbow ache, i barely can do work out, like push up, lifting etc, what am i supposed to do? Is there any chance to make it well again??
Sorry for my bad English, i hope anyone will answer my question..
I’m facing the same issue right now😞
Nice voice ea.... Imagine dark vader/ batman have this voice..lol
Why we shouldn't Radial head excision when elbow dislocated.. U didn't tell the reason
i broke my arm and dislocated my elbow about 5 years ago, had surgery with 9 screws and plate, I still can not straighten my arm fully and I also get pain in the joint still. I was told by the doctors that the pain should go but 5 years later its still there, so i've come to the conclusion that it will remain there for the rest of my life which sucks.
Why haven't you gone to a doctor
👍
I have a simple elbow dislocation when i was still 6 years old.i am now 35 and want to fix it..what should i do?
Did you get to fix your elbow?
Me too bro
I have a bad dislocation in my elbow
Me too bro I have 10 years ago Elbow dislocation... So, I feel hurt when it comes physical activities in our school that's why I look down my self because of my elbow dislocation :(
same bro losing confidence because of this @@johnandreeberong9543
👍👍👍👍👍
Im a dislocated elbow what i will
NICAPOTPOT CHANNEL what
Thank you