From the Research
The most common type of elbow dislocation is the posterior dislocation, accounting for approximately 90% of all elbow dislocations. This occurs when the forearm bones (radius and ulna) are displaced posteriorly relative to the humerus, typically resulting from a fall onto an outstretched hand with the elbow in slight flexion. Posterior dislocations often involve damage to the anterior capsule and collateral ligaments, particularly the lateral collateral ligament complex.
Key Points to Consider
- Treatment generally involves closed reduction under appropriate sedation or anesthesia, followed by a brief period of immobilization (typically 5-10 days) in a posterior splint at 90 degrees of flexion, and then early controlled motion to prevent stiffness, as noted in studies such as 1.
- Most patients can expect good functional outcomes with proper management, though some may experience residual stiffness or mild instability, as discussed in 2.
- Complications can include recurrent instability, heterotopic ossification, or neurovascular injuries, particularly to the ulnar nerve, highlighting the importance of careful evaluation and management, as emphasized in 3.
Management and Outcomes
The management of posterior elbow dislocations requires careful attention to potential neurovascular injuries and associated fractures, as highlighted in 4. Early recognition and treatment of these complications are crucial to preventing long-term morbidity and improving outcomes.
Recent Evidence
Recent studies, such as 2, have reinforced the importance of non-operative management for simple elbow dislocations, with good long-term outcomes reported for the majority of patients. However, a small proportion of patients may require surgical intervention due to poor outcomes or complications.
Clinical Implications
In clinical practice, it is essential to prioritize the identification and management of potential complications, such as neurovascular injuries, to minimize the risk of long-term morbidity and improve patient outcomes, as noted in 3. By following a careful and evidence-based approach to the management of posterior elbow dislocations, clinicians can optimize treatment outcomes and reduce the risk of complications.