I recently underwent a surgical repair for a fractured ulna and dislocated elbow. What should I expect with long term recovery and using my elbow again?



There are several factors that influence the outcome of an ulnar fracture with dislocation. Firtst, time from injury to treatment will effect outcomes. Patients treated within two weeks of injury have significantly better outcomes than those treated more than two weeks after injury when assessing range of motion, pain, and outcome measures. Type or extent of instability will also effect outcomes. Most acute simple dislocations are stable once the joint has been concentrically reduced, the ligaments will heal and function with early controlled motion. A nonacute simple dislocation, persisting beyond two weeks, can still be successfully treated with concentric reduction and early motion, however longer standing dislocations can also require surgical repair as the LCL is not successfully healing to the lateral epicondyle. These instabilities result in less favorable functional outcomes.

There is no consensus on what the optimal solution is for assuring stability of an elbow that has dislocated or subluxed. Temporary immobilization with either cross pinning or external fixation is most commonly used to help maintain elbow congruency while healing. An external fixator, however is difficult to apply, cumbersome to wear, can sometimes still allow the elbow to dislocate and can cause pin-site infection, pin breakage and/or radial nerve injury. Cross pinning of the joint is better at maintaining reduction, but the arm must be casted and there are risks of pin breakage and septic arthritis.