Elbow Fractures and Dislocations

Fractures around the elbow involve either the distal humerus, the proximal ulna or radius. They occur in differing patterns according to the mechanism of injury. The direction and degree of force of the injury will dictate how extensive the injury to the bones and surrounding capsule, ligaments, muscles and tendons is. In rare instances the nerves or significant vessels crossing the elbow may be injured, and will require urgent repair.

Elbow dislocations may be classified as simple (without an associated fracture) or complex (with an associated fracture). Again, the degree and direction of the force will dictate the pattern and extent of the injury.

As a general principle, it is important to reduce all dislocations quickly in a safe and controlled manner. This relocates the joint, taking the tension off the soft tissues and preventing further injury to the elbow.

Management of elbow dislocations

Over 90% of simple elbow dislocations only require relocation and some rehabilitation to regain range and strength. Around 8% of patients with significant ligament injuries around the elbow present with ongoing symptoms of instability, but with dedicated rehab only a quarter of these require surgical ligament reconstruction to stabilize it.

  • Management

Due to the complexity of the varying presentation of elbow fractures, injury specific management is indicated and it is impossible to define exactly what each fracture configuration requires to achieve an optimal outcome. Broadly speaking most elbow fractures will require operative fixation. It is important that this be undertaken by someone familiar with the different types of elbow injuries, as certain fractures require good operative fixation due to being significant risk factors for post-traumatic arthritis if not fixed.

Conditions Managed

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