What causes posterior elbow dislocation?
The elbow joint is formed by two bones (the radius and ulna) of your forearm and one bone (the humerus) of your upper arm. When one or both bones of your forearm slip out of the joint, the condition is known as an elbow dislocation.
An elbow dislocation is the second most common dislocation after a shoulder dislocation.
When the ulnar bone slips out to the back of your elbow, the condition is known as a posterior elbow dislocation. Nearly 90% of all elbow dislocations are posterior elbow dislocations.
The posterior elbow is dislocated when you fall on your extended arm. It is more common in adolescent athletes, particularly those who are engaged in sports such as football and wrestling.
How is posterior elbow dislocation diagnosed?
Your doctor will obtain a thorough history regarding your elbow injury and examine your elbow carefully.
In general, your doctor will recognize a posterior elbow dislocation from your complaints such as severe pain in the elbow, swelling, and inability to bend your elbow.
Some arteries and nerves run through your elbow, and they may get injured when the elbow is dislocated. Hence, your doctor will check if you have injured any of these surrounding nerves or arteries. He will ask you if you have lost sensations in your hand and check if your pulse is being felt.
Your doctor will order for a few X-rays of your elbow in different positions to confirm the diagnosis of a posterior elbow dislocation and to check if there is any associated fracture in any of the bones.
What is the reduction of posterior elbow dislocation?
The reduction of posterior elbow dislocation is a procedure in which the displaced bone is aligned correctly in the joint and restored to its original position by pulling or pushing it.
Simple posterior elbow dislocations are treated with a closed reduction procedure—performed manually and externally (without opening the elbow surgically).
Complex posterior elbow dislocations (those with associated fractures) require a surgery.
For reduction of a posterior elbow dislocation
- You will be given sedative and pain reliever to keep you at ease through the procedure.
- You will be instructed to lie down facing up.
- Your doctor will bend your elbow and gently rotate your forearm till your palm faces up.
- Your doctor will then hold the upper arm down and simultaneously pull the wrist up until the joint is back in place.
What is done after the reduction of posterior elbow dislocation?
Your doctor will check your elbow joint for stability, and an X-ray is taken to ensure that the procedure was successful in fixing your elbow dislocation.
You will be observed for approximately two to three hours after the reduction procedure. Once the doctor confirms there is no injury to your artery, you will be sent home with the schedule of your next follow-up.
Elbow support in the form of a posterior long-arm splint, made of plaster or fiberglass, will be applied to the successfully reduced arm. This splint helps in keeping your elbow immobile and needs to stay around your elbow for approximately a week or until the pain and swelling go away.
After the splint is removed, you need to put an arm swing for approximately two to three weeks.
What are the risks involved in the reduction of a posterior elbow dislocation?
The most serious risk of joint reduction for a posterior elbow dislocation is an injury to a major artery (brachial artery) that supplies blood to your arms and hands. Your doctor will check for signs of a brachial artery injury after reduction.
If he cannot feel your pulse near your elbow, he will loosen the splint and reduce the degree of bend at your elbow. If the pulse is not restored, your doctor will immediately refer you to a surgeon to determine the need for an emergency X-ray (arteriography) of your brachial artery and subsequent surgery to repair the artery.
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