elbow dislocation
TRANSCRIPT
ELBOW
DISLOCATIONS
Joints of the ElbowJoints of the Elbow
• Hinge jointHinge joint• Composed of 3 articulations:Composed of 3 articulations:
1. Humeroulnar joint1. Humeroulnar joint
2. Humeroradial joint2. Humeroradial joint
3. Radioulnar joint3. Radioulnar joint
The Elbow JointThe Elbow Joint
Ligaments of the ElbowLigaments of the Elbow
Ulnar Collateral LigamentUlnar Collateral Ligament
medial side – connects humerus to ulnamedial side – connects humerus to ulna
Radial Collateral LigamentRadial Collateral Ligament
Lateral side – connects humerus to radiusLateral side – connects humerus to radius
Annular LigamentAnnular Ligament
Surrounds radial head/holds it tight Surrounds radial head/holds it tight
to ulnato ulna
Elbow DislocationsElbow Dislocations
• 20% of all dislocations20% of all dislocations• Second most commonly dislocated majorSecond most commonly dislocated major
joint of the body behind the shoulderjoint of the body behind the shoulder• Associated fracturesAssociated fractures• – – Radial head/neck 50-60%Radial head/neck 50-60%• – – Medial/lateral epicondyle 10%Medial/lateral epicondyle 10%• – – Coronoid process 10%Coronoid process 10%
Elbow dislocationElbow dislocation
• Usually fall on the Usually fall on the wrist or hand with wrist or hand with the elbow in the elbow in extension.extension.
• Severe pain at Severe pain at elbow and swellingelbow and swelling
• Minimal movementMinimal movement
classificationclassification
Clinical featuresClinical features
Severe pain at the elbow
Triceps tendon stands prominent(bowstringing of triceps)
The 3 bony-points relationship is reversed
Associated median nerve palsy
Diagonosis is often confirmed on X-rays
X-RAYS
Posterior dislocation of elbow
Medial dislocation of elbow
Divergent dislocation of elbow
Dislocation of the RadiusDislocation of the Radius
• The radial head may be displaced The radial head may be displaced forward, backward, or outwardforward, backward, or outward
• Children under 5 are prone to Children under 5 are prone to subluxation of the radial head due to subluxation of the radial head due to a “pulling” on the forearm a “pulling” on the forearm
Pulled elbow or Nursemaid’s armPulled elbow or Nursemaid’s arm
TreatmentTreatmentIt is by reduction under anaesthesia followed by immobilisation in an above-elbow plaster slab for 3 weeks
complicationsElbow stiffness
Myositis
Injury to brachial artery and median nerve
Compartment syndrome
Fracture of head of radius & coronoid process
Fracture & entrapment of medial epicondyle
heterotropic ossification (formation of bone where it is usually not seen as in muscles and fascia).