Elbow Dislocation / Instability
Three bones come together to make up the elbow. These bones are the arm bone (humerus) and two forearm bones (radius and ulna). The bones have very distinct shapes so that they fit together closely. The elbow joint is further stabilized by ligaments that helps hold the bones together.
After a fall, collision, or motor vehicle accident, the elbow may come out of socket (dislocate). If the elbow dislocates and no broken bones (fractures) are noted, it is known as a simple dislocation. Other dislocations involve fractures to the bones of the elbow. These are known as complex dislocations. Elbow dislocations are very painful, and patients are usually seen in the emergency department where the elbow is put back into place (reduced).
Most patients with simple dislocations are able to be treated without surgery. Usually protecting the elbow in a splint for 2-3 weeks allows time for the soft tissues to heal and the elbow to remain stable. Some patients with complex dislocations or elbows that remain unstable after splinting may need surgery. During surgery, the fractures around the elbow are fixed with plates and screws, or occasionally replaced with a metal replacement. Torn ligaments are repaired back to the bone. If it has been several weeks since the initial injury occurred, the torn ligaments may need to be reconstructed using donor tendons from the patient's arm, or a cadaver.
After surgery, patients will be immobilized in a splint or a brace to protect the elbow while the tissues heal. Physical therapy will begin within the first few weeks after surgery to regain range of motion. Some patients may have difficult fully straightening (extending) the elbow after an elbow dislocation. Fortunately, the elbow functions well even if some range of motion is lacking.
Further information on this injury can be found in this article on the AAOS OrthoInfo website, an orthopaedic resource center providing expert information.
Frequently asked questions
What causes elbow instability?
Elbow instability can follow a dislocation, ligament injury, fracture, or repetitive stress in throwing athletes.
Can elbow instability heal without surgery?
Some injuries improve with protection, therapy, and bracing, while persistent instability may require surgery.
When is surgery recommended after elbow dislocation?
Surgery is considered when the joint remains unstable, associated fractures are present, or function does not recover with conservative care.