The elbow is normally a very stable, solid joint. It doesn’t dislocate easily. But when a traumatic injury occurs and enough force is placed on it, fracture and dislocation can be the result. In this continuing medical education (CME) article, orthopedic surgeons from the Hand and Upper Extremity Service at Massachusetts General Hospital in Boston present an update on the surgical repair of traumatic elbow instability.
Injuries from a sudden fall that result in a simple dislocation can damage any of these soft tissue structure. “Simple” means there is no bone fracture.
More complex elbow dislocations involve fractures of any of the bones that make up the joint. This can include either of the bones in the forearm (radius, ulna) or the bottom of the humerus (upper arm bone) where it joins the forearm bones to form the elbow. The exact type of elbow dislocation and which soft tissues or bones are affected depends on the force(s) placed on the elbow at the time of the injury.
Simple elbow dislocations can often be reduced (put back in place) without surgery. More complex dislocations require a surgical procedure to reduce the joint and repair the damage.
Long-term problems that can occur after a traumatic elbow injury include chronic, recurrent elbow dislocations, joint stiffness, and/or eventually degenerative changes in and around the joint.
The goal of treatment is to restore joint stability and prevent these kinds of problems. The bottom line is that a stiff but located (in place) joint is easier to save than one that is so damaged that the joint surface has been disrupted.