Elbow dislocated

A dislocation of the elbow occurs much less frequently than a dislocation of the shoulder. It often occurs when external force is applied, such as falling onto the outstretched or slightly pronounced (palm is turned downwards) arm. Very often a dislocation is accompanied by concomitant injuries.

In the case of a dislocation, the spoke head (caput radii) and/or the end of the ulna facing the body, the olecranon, slips off the distal (distal to the body) end of the humerus, so that the three parts of the bone are no longer properly aligned – they are displaced. In principle, a dislocation in the humeroulnar joint, i.e. the joint part between the humerus and ulna, is more common than a dislocation between the radius and the humerus. Very common is a dislocation to the back or back-outside.

The ligamentous apparatus at the elbow joint can tear in or out just like the capsule. It is not uncommon for fractures (broken bones) to occur in the humerus, the olecranon of the ulna or the radial head. Unpleasant complications are injuries to arteries, veins and nerves running near the joint.

The humerus with its joint roller (trochlea humeri) slides backwards or backwards-outwards out of the bony depression of the ulna, which is formed by the olecranon. At the same time, however, there is also a shift in the connection between the upper arm and the radius. In the process, the radial head slides with its joint surface from the humeral head.

A ventral dislocation, in which the humerus moves in front of the ulna and radius, is rather rare. Lateral or divergent dislocation is also rare – ulna and radius move to different sides of the humerus. The restoration (repositioning) of the original joint position should be carried out within a few hours to avoid consequential damage.

This is done under general anesthesia by bringing the joint back to its original position with jerky movements, depending on which dislocation is present. After a short period of immobilization (1-2 weeks), physiotherapy is performed. In the case of possible concomitant injuries, such as ligament and bone damage, surgery is indicated to repair the damage.

A special form of elbow luxation is the dislocation of the radial head in small children. In this case, the caput radii slips out of its articulated connection and is trapped by a part of the ligamentous holding apparatus, the ligamentum anulare radii.This often happens when small children are held by their parents’ hands and are protected from falling. The force acting on the head of the radius cannot be held by the ligamentous apparatus, which is not yet very stable, and dislocation occurs.

After such an incident, the children hold the arm in a protective position in which the arm and hand are slightly not turned inwards (pronation), hence the name pronatio dolorosa (painful pronation). No surgery is necessary to restore the original position of the radial head. It can be restored by an experienced physician in a few simple steps.