Elbow dislocation

Case contributed by Tatiana Gellein

Presentation

Left elbow injury during wrestling.

Patient Data

Age: 16
Gender: Female
X-ray

1. Three views of the left elbow demonstrate significant deformity with posterolateral dislocation at the elbow joint.

2. No definite evidence of a displaced fracture. Tiny high densities seen adjoining the head of the radius, may represent avulsion injury.

3. Small elbow joint effusion. Significant soft tissue swelling around the elbow with gross deformity.

 

X-ray

1. Anatomic alignment is noted at the left elbow joint status post successful reduction of posterolateral dislocation of the left elbow.

2. No definite evidence of a displaced fracture.

3. Tiny densities noted adjoining the head of the radius appear stable.

4. Much improved deformity of the elbow with persistent significant soft tissue swelling and small elbow joint effusion.

Case Discussion

Ninety percent of all elbow dislocations are classified as posterior or postero-lateral dislocations, typically found in the non-dominant upper extremity. The most common mechanism of injury is a traumatic fall on an outstretched hand, resulting in hyper-extension. 

The incidence of elbow dislocations in the US (NEISS database) 5.21 per 100,000 person-years, with the highest risk group occurring in adolescents. For patients greater than 10 years old, nearly 50% of elbow dislocations are due to sports. The three events with the highest incidence of elbow dislocations include football, skating/skateboarding, and wrestling.

For males, football, basketball and wrestling were the most frequent events, while for females, gymnastics and skating.

Simple dislocations (~75%) without evidence of fracture are promptly treated with closed reduction. Complex dislocations (~25%) with fractures may require surgery for stabilization.

This case was submitted with supervision and input from:

Soni C Chawla, MD
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center

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Case information

rID: 62112
Published: 3rd Sep 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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