Elbow Dislocation

Medically Reviewed by Poonam Sachdev on April 12, 2023
Written by WebMD Editorial Contributors
6 min read

 

An elbow dislocation happens when the bones of the forearm (the radius and ulna) move out of place, compared with the bone of the upper arm (the humerus). The elbow joint, formed where these 3 bones meet, becomes dislocated, or out of joint.

Specific, serious injuries that may occur are fractures (breaking of the bones in the arm), injuries to the arteries in the arm (the vessels carrying blood to the hand), and injuries to the nerves that run through the elbow area, impairing movement and feeling in the arm and hand.

The cause of most elbow dislocations is usually a fall, most commonly with the arm all the way out. But any traumatic injury (such as a car crash) can result in an elbow dislocation.

Severe pain in the elbow, swelling, and not being able to bend your arm are all signs of an elbow dislocation.

In some cases, you may lose feeling in your hand or no longer have a pulse (can't feel your heartbeat in your wrist). Arteries and nerves run by your elbow, so it is possible you might have injured them during the dislocation.

You should go to the doctor's office or hospital's emergency department right away if you can't move your elbow, have severe pain, can't feel your hand, or have no pulse in your wrist.

The doctor will begin with an examination.

  • The doctor will make sure your nerves and arteries are unhurt by checking your pulse, making sure you can feel normally, moving your fingers and wrist, and making sure that blood is flowing normally to your hand.
  • Next, the doctor will get X-rays. Sometimes, breaks in the bone can look like dislocations, and some breaks happen when dislocations happen.
  • If the doctor suspects an injury to your artery, further tests, such as an arteriogram (an X-ray of your artery) may be done. Sometimes, an MRI or CT scan may be needed. 

An elbow dislocation is a serious injury that needs medical care. At home, put ice on the elbow. This will help with the pain and will reduce some of the swelling. But the most important thing to do is to see a doctor.

It is best for a doctor to examine this injury, but at home, you can also check for a few signs that will show if the artery in the arm and the nerves are intact.

  • To check on the artery, feel below your thumb at the base of your wrist. You should be able to feel your pulse. Press on the tips of your fingers. They should blanch (turn white) and then return to a normal pink color within 3 seconds. If either of these tests is abnormal, seek medical care right away.
  • Three nerves run by the elbow. Each nerve has portions that help with strength and feeling. First, check for strength by bending your wrist up as if you were saying "Stop" (radial nerve function), then spread your fingers apart (ulnar nerve function), then try to touch your thumb to your little finger (median nerve function). If you have trouble with any of these tests, see a doctor right away.
  • Check for feeling by touching all over your hand and arm. If any feeling of numbness results, see a doctor right away.

There are three basic kinds of elbow dislocation:

  • A simple one doesn’t involve a major bone injury.
  • A complex one does have broken bones. You might need surgery to fix it.
  • A severe dislocation involves injured blood vessels and nerves. 

With a complex dislocation, surgery to repair the damage may lead to bone growth in the soft tissue in your elbow. If this happens to you, your doctor may call it “heterotopic ossification.”

The doctor will reduce (put back in place) your elbow by pulling down on your wrist and levering your elbow back into place. This is very painful, so powerful medications for pain may be given before reduction.

After your elbow is back in place, the doctor will get X-rays and then put you in a splint that will keep your elbow bent. The splint will make an "L" around the back of your elbow. It will be made of plaster or fiberglass. Its purpose is to prevent movement of your arm at the elbow. Usually, your arm will be placed in a sling to help you hold up your splint.

After you are sent home from the doctor's office, you will be told to follow up with a bone doctor (orthopedist).

Wear your splint. Do not move your elbow. Elevate your elbow as much as possible, and ice it to ease swelling.

Complex dislocations that need surgery are tougher. Sometimes it’s better to delay the operation. This gives the swelling time to go down. It may be best to rest your elbow in a brace or splint for about a week before surgery.

 

 

Your physical therapist will create a rehab program just for you. Here’s what a basic post-op routine might look like:

  • 1-4 weeks: Keep your elbow raised. Use ice to ease swelling. Use a splint when you’re still, but you will do some range-of-motion exercises. Your physical therapist may massage the area – they might call this soft-tissue mobilization.
  • 5-8 weeks: You’ll add exercises with and without weights to your range-of-motion routines. If you’re an athlete, you’ll work in some sport-specific activities, too. And you’ll continue the soft-tissue treatments.
  • 9-16 weeks: By now, you'll have full range of motion and normal strength in your elbow. You should be back to doing what you did before the injury.

Do not fall on your outstretched arm. Avoid situations that would make falls more common (such as walking at night or being around slippery floors. Overtraining in sports, especially ones that involve throwing, can also lead to dislocation. 

Generally, this injury heals well. After watching closely for 3-5 days, the bone doctor will have you begin gentle movement exercises of your elbow. Usually, recovery happens without any lasting effects.

You may be more likely to take your kid in for this kind of injury than to get one yourself. There’s a type of partial dislocation called nursemaid’s elbow, or pulled elbow, and it’s common in tots 4 and younger.

It usually happens when you pull children by their hands. Their ligaments are loose because their bones aren’t fully formed. It’s easy for them to slip right over the radial head – the thing that helps them flex and bend their elbow and forearm – or get trapped in the elbow joint.

It happened to Bethany Afshar’s daughter Katie twice. The first time was when she was almost 2 and ran behind her big brother into a swimming pool. Her father quickly pulled her out of the pool by her left arm.

“Later, we noticed that she couldn’t pick up a pacifier with that arm and took her to urgent care,” says Afshar, who lives in Georgia. “They gave her a Popsicle, lifted her arm and twisted it real quickly back into place, just like that.”

Katie got the same treatment after it happened again in preschool a year or two later, “probably on the jungle gym,” Afshar says. Katie is 9 now, and it hasn’t happened since. The risk drops as kids get older – their ligaments tighten and their bones grow.

“Nursemaid’s elbow is one of my favorite diagnoses, because it’s so fixable in the moment,” says Kate Cronan, MD, an emergency room physician at Alfred I. DuPont Hospital for Children in Wilmington, DE. “It’s rare that we can fix something that easily and make a child feel all better that quickly.”