Elbow dislocation: Causes, symptoms and treatment
- 2 days ago
- 5 min read
Elbow dislocation – also known colloquially as a "dislocated" or "dislocated elbow" – is the second most common joint dislocation in adults after shoulder dislocation. It primarily affects young, athletically active people.
In this injury, the bones of the elbow joint – humerus, ulna, and radius – lose their normal contact with each other. While the injury may initially seem straightforward, it is often accompanied by other injuries that are easily overlooked and can have long-term consequences.
In this article you will learn:
What causes an elbow dislocation?
How the diagnostic process works
What treatment options are available?
When surgery is advisable
What aftercare looks like
The good news: If the injury is detected early and treated correctly, most patients can regain very good elbow function.
What is an elbow dislocation?
In an elbow dislocation, the joint surfaces of the elbow lose their normal contact with each other. In addition to the bones, ligaments, cartilage, muscles, and joint capsule can also be injured.
A distinction is made between:
Simple elbow dislocation: pure ligament injury without bone fracture
Complex elbow dislocation: additional fractures or more serious accompanying injuries
Complex injuries often require surgical treatment by an experienced elbow specialist.
How does a dislocated elbow occur?
The most common cause is a fall onto an outstretched hand – this puts rotational forces on the joint, causing the ligaments to tear. In approximately 80–85% of cases, the forearm twists backward (so-called posterior dislocation).
Typical causes include:
Fall onto an outstretched arm – e.g., during sports, cycling, or tripping.
Direct impact on the elbow
Sports accidents in martial arts, climbing or contact sports
Chronic overuse in throwing athletes (e.g., handball, baseball)
What are the typical symptoms?
An elbow dislocation is usually immediately and clearly noticeable:
Sudden, severe pain immediately after the accident
Visible misalignment of the elbow
Swelling and bruising within minutes
Loss of mobility – bending and stretching hardly possible
Tingling or numbness in the little finger or ring finger area
Important: If you suspect an elbow dislocation, seek immediate medical attention or go to the emergency room. Attempting to realign the elbow yourself is dangerous and can injure nerves or blood vessels.
What should you do immediately after an accident?
Keep arm still
Cool
Do not attempt to realign the joint yourself.
Go to an emergency room or see a trauma surgeon as soon as possible.
Diagnostics
The diagnosis can often be suspected based on the clinical examination. This is followed by imaging studies.
X-ray: Standard examination to detect dislocation
CT scan: in case of suspected bone injuries
MRI: for assessing ligaments, cartilage and soft tissues
Stability test after reduction: The crucial test – shows whether the joint is stable or prone to re-dislocation.
It is particularly important to identify possible accompanying injuries, as these significantly influence the treatment.
Conservative treatment
In the case of a simple dislocation without an accompanying fracture, conservative therapy is the treatment of choice – with very good long-term results:
First, the joint is reduced (repositioned) under brief general anesthesia . This is followed by a short period of immobilization in a splint for approximately one week before physiotherapy begins.
Studies show that the earlier exercise begins, the better the outcome. Prolonged immobilization significantly increases the risk of permanent movement limitations. Anti-inflammatory medication and cooling during the first few days can also be helpful.
When is surgery necessary?
Surgery is necessary in the following cases:
Instability after reduction – the joint tends to dislocate again.
Associated fractures (e.g., radial head, coronal process)
Severe ligament damage
Important: Surgical repair of the ligament must be performed within 14 days of the accident. After this time, rapid scarring sets in, making a direct suture no longer reliably possible.
Band seam and internal bracing
Torn ligaments are reattached directly to the bone using suture anchors. The so-called "internal bracing" technique has also proven effective – reinforcement with a non-absorbable ligament tape that provides immediate stability and allows for early movement after surgery.
Treatment of accompanying fractures
Depending on their severity, bone fractures are fixed with screws or plates. In the case of comminuted fractures of the radial head that cannot be reconstructed, a prosthesis can also be used. Simply removing the radial head without replacement should be avoided – it can lead to permanent instability.
Ligament reconstruction for chronic instability
If persistent instability remains after a poorly healed dislocation, tendon grafts (e.g., the gracilis tendon from the thigh) are used to permanently reconstruct the ligaments. This is also the treatment of choice for throwing athletes with chronic ligament wear.
Specific injury patterns
Some patients also experience bone fractures. A well-known combination is the so-called "terrible triad" of the elbow. This involves elbow dislocation and fractures of important bony stabilizers.
These injuries usually require surgical intervention and close follow-up care.
Healing time and rehabilitation
Injury | Typical healing time |
Simple elbow dislocation | 6–8 weeks |
Surgically treated injury | 3–6 months |
The individual healing time depends on age, activity level and the extent of the injury.
Structured physiotherapy is crucial for restoring mobility, strength, and coordination.
When will sports be possible again?
In uncomplicated cases, sporting activities can often be resumed after 8 to 12 weeks. Contact and high-risk sports often require a longer rehabilitation period.
Following surgery, clearance is granted individually by the treating specialist.
Possible complications
Permanent limitation of movement
Chronic instability
Nerve irritation
Ossifications in the soft tissue
Premature joint wear
Early treatment and consistent follow-up care help to minimize these risks.
What are the chances of recovery?
The prognosis after an elbow dislocation is usually very good. Crucial factors are a rapid diagnosis, the right treatment, and consistent rehabilitation.
Most patients can resume their daily activities without restrictions.
Why go to an elbow specialist?
Complex elbow injuries are among the most challenging injuries of the upper extremity.
Undetected accompanying injuries can lead to instability, pain, or restricted movement in the long term.
Specialized diagnostics and treatment improve the chances of a lasting good outcome.
Conclusion
Elbow dislocation is a serious injury that requires immediate medical treatment.
In the case of simple dislocations, realignment followed by physiotherapy is sufficient in most cases – with very good long-term results.
Surgery is necessary in cases of accompanying fractures or persistent instability – and should be performed within 14 days.
Approximately 50% of all elbow dislocations are accompanied by bone fractures – therefore, thorough diagnostics are essential.
Early physiotherapy is the most important factor for a good outcome.
Whether and which type of surgery is advisable should always be discussed individually with an experienced elbow specialist.
Frequently Asked Questions (FAQ)
Does every elbow dislocation require surgery? No. Many simple dislocations can be successfully treated without surgery.
How long does the healing process take? Depending on the injury, between six weeks and several months.
Can the elbow dislocate again? The risk is lower than with the shoulder, but can occur if the elbow is instability.
When can I resume sports? Often after 8 to 12 weeks, later in the case of complex injuries.
Are you experiencing discomfort after an elbow injury?
Then make an appointment with our specialist :
Priv.-Doz. Dr. med. Johannes Gleich
Specialist in Orthopedics
and trauma surgery,
Emergency medicine
