The elbow is essentially a hinge joint, relying on a combination of highly congruent bony anatomy and surrounding ligaments to maintain its stability. It is the second most commonly dislocated major joint behind the shoulder.
Elbow dislocations can occur at any age and are most commonly a result of a fall onto an outstretched arm. A combination of load through the elbow as well as bending and twisting forces can result in injury to the ligaments and bones of the elbow and subsequent elbow dislocation.
Dislocation of the elbow will often result in significant damage to both the soft tissues (ligaments, joint capsule and sometimes tendons) as well as the bones of your elbow joint. It can be a complex injury and is best managed by a surgeon highly experienced in surgery of the upper limb. Timely and comprehensive clinical and radiological assessment will determine whether or not surgery will be required to stabilise your elbow and maximise long-term movement and function.
Surgical Treatment of Elbow Dislocation
Surgery for elbow dislocations can involve a number of individual techniques – usually a combination of the following:
Certain fractures associated with elbow dislocations have a significant effect on the resultant stability of the elbow. Where possible, these fractures will be fixed back in place and usually stabilised with specifically designed plates and/or screws.
A degree of ligament damage is inevitable following dislocation. Most often ligaments rupture from the point where they attach to the bone. To repair ligaments back to bone at the time of surgery we will often use an implant called a suture anchor. This is essentially a small screw that is placed into the bone and has a number of sutures (stitches) attached to it that are passed through the ligament before being tied back down to the bone.
Radial Head Replacement
In certain cases the radial can be so badly damaged that it cannot be repaired. The radial head, however, plays a critical role in keeping the elbow joint stable so it can not be simply ignored or excised. In these cases a radial head replacement can be implanted to reconstruct the normal anatomy of the elbow.
Following surgery your arm will be placed in sling or sometimes a temporary plaster splint. Dr Alexander will tailor a rehabilitation program to your individual injury and work closely with a physiotherapist to guide you through this process. Especially in the early stages, rehab is a delicate balance of protecting the surgical repairs that have been performed and getting the elbow moving to prevent stiffness. This injury will affect your ability to work and drive and Dr Alexander will work closely with you so that you have an understanding of when it will be likely that you will be able to return to these kinds of activities.