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Elbow Dislocation
WHAT IS AN ELBOW DISLOCATION?
Elbow Dislocation occurs when the surfaces of an elbow are separated.
Elbow dislocations can be complete or partial. A complete dislocation is
referred to as a dislocation; a partial dislocation is referred to as
asubluxation. Complex and complete dislocations often involve injury to
bone, ligaments, nerve and surrounding blood vessels. In extreme cases
trauma such as this can lead to a high risk of losing an arm.
WHY DOES A DISLOCATION OCCUR?
Although dislocation of the elbow is uncommon, there are two main causes
for dislocation or subluxation and they are: -
a) Traumatic Dislocation - caused by an individual experiencing a
significant or high impact which both rotates and forces the elbow out
of its socket. This is an injury that is frequently sustained in road
traffic accidents where the crash victim braces them self on a car
dashboard with outstretched arms prior to impact.
b) Atraumatic or Positional Dislocation - caused by abnormally lax joints
and/or cartilage that fail to support and hold the elbow joint in place
(patients with this condition are often referred to as 'double jointed'). In
addition, a small number of individuals are born with an overly shallow
groove for an elbow hinge joint which makes them highly prone to
developing sublaxation.
Elbow Dislocation usually compromises the
ability of an individual to bend, straighten and rotate their arm. This
condition is extremely painful and usually presents as a perfectly
obvious picture because of the externally deformed and twisted
appearance of the affected joint.
HOW IS AN ELBOW DISLOCATION TREATED WITHOUT SURGERY?
Elbow Dislocation can be treated conservatively by manipulating the elbow
back into its correct position, treating any pain with painkillers and anti-
inflammatory medication and gradually training the surrounding ligaments
and muscles to tighten and support the joint through physiotherapy. The
short-term aim of this procedure (known as a reduction manoeuvre) is to
restore alignment of the elbow joint; the long-term aim is to restore a full
range of elbow function. However, an unstable elbow joint that repeatedly
dislocates is unlikely to respond well to this type of non - surgical
intervention and will typically require surgery.
HOW IS AN ELBOW DISOCATION TREATED WITH SURGERY?
A surgical procedure to resolve a dislocation is usually performed under
general anaesthetic and takes around one to two hours to complete,
dependant on the complexity and extent of the dislocation and surrounding
trauma.
An operation to resolve a complex dislocation is usually provided
through a traditional incision (also known as an open procedure) during
which the Consultant Orthopaedic Surgeon will carefully explore, repair and
restore any fragments of bone or torn ligaments, vessels and/or nerves.
The ultimate aim of reconstructive surgery such as this is to eliminate the
dislocation problem as well as restore nerve sensation, blood circulation
and a full range of joint movement. However, due to the complexity of this
type of operation it is often necessary to reconstruct the elbow over a
number of staged procedures.
WHAT IS THE RECOVERY AFTER SURGERY LIKE?
Once a patient is fully recovered from the effects of anaesthetic they are
normally quickly encouraged to be as active and mobile as possible to
avoid joint stiffness and other complications such as Deep Vein
Thrombosis (DVT) from developing. It is therefore normal for patients to be
encouraged to take a short walk and perform gentle postoperative
exercises with guidance from a physiotherapist on the day of surgery.
Following a progressive improvement of mobility and pain control patients
are normally discharged from hospital two to three days following surgery.
By the time the required level of recovery is achieved for discharge, patients
are normally fully mobile, wearing a light weight dressing and support sling
on the effected elbow, eating and drinking normally and taking only mild
analgesia (pain killers).
Over the next six weeks patients will be expected
to work on improving their effected joints mobility and stability through a
dedicated and progressive upper limb physiotherapy regime. Your
Consultant Orthopaedic Surgeon will assess your joints stability and range
of movement after six weeks and then again after three months to evaluate
how successful your elbow procedure has been. Patients should expect a
continuous and full physical recovery to take around nine to twelve months
to achieve.
ARE THERE ANY RISKS ASSOCIATED WITH ELBOW DISLOCATION SURGERY?
Although corrective Elbow Dislocation surgery is more commonly and
successfully performed today than it has ever been, it is considered a
specialist and complex procedure to perform or revise. It is therefore very
important that all candidates are fully aware of both the benefits and risks
of undertaking such specialist surgery and the importance of a full
consultation to discuss your condition with a specialist Upper Limb
Orthopaedic Surgeon in relation to these risks cannot be over emphasised.
HOW DO I FIND OUT IF I AM A SUITABLE CANDIDATE FOR A DISLOCATION REPAIR PROCEDURE?
At NW Specilaist Clinic our Consultant Orthopaedic Surgeons will carry
out a full evaluation of your individual symptoms and circumstances and
provide you with a comprehensive verbal and written explanation of your
condition, recommending the most appropriate solution to improve your
condition.
Our specialist Consultant Orthopaedic Surgeons understand the
importance of the decision you are making when contemplating corrective
elbow surgery. Throughout your consultation you will be encouraged to ask
as many questions as you wish and to take your time in making a decision
to proceed with any recommended treatment.
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