Question
What is they typical managment for a simple elbow dislocation?
Answer
A simple dislocation is going to require a closed reduction. There are no fractures in a simple dislocation. If the joint is stable after reduction, we can start with immediate active range of motion in a pain free range. We want to get them moving right away, but not cranking into pain. Typically they'll be given compression garments to control swelling, and then we can also start working on gripping. Now, if the joint is deemed to be unstable after reduction, they'll typically be immobilized, in either a cast or a brace. According to the literature, if immobilization is greater than 14 days, or 2 weeks, we see a much higher risk of stiffness, even in the individuals that have instability after reduction with a simple dislocation. In other words, a dislocation without any fractures is only soft tissue related. If it's unstable after reduction, they'll be immobilized but for a relatively short period of time, typically no longer than 2 weeks.
It’s also important to work on pronatory and supintory strength to provide stability in and through the joint. When we look at the restraints of both varus and valgus force at the elbow, and think about where those muscles cross-like other parts of the body, if we have damage to the ligamentous structures, we have to start thinking about how can we augment the dynamic structures, or the contractile tissue to be there to help provide some stability. In the elbow, that's going to be working on pronation and supination strength.
