Approach to simple elbow dislocations in the emergency department

Abstract

Elbow dislocation is a frequent injury when it comes to involvement at the level of the elbow joint, it mainly affects males and is considered the most frequent dislocation in children. It is classified depending on the involvement of the lesion in simple dislocation, when it is not associated with a fracture, or complex, when it is associated with a fracture or joint instability. Another classification is according to the direction of displacement, which 80% of the time is posterolateral, while the other 20% comprises posteromedial, anterior, or divergent displacements. In children, a radial head subluxation known as "Pulled Elbow" occurs frequently, it occurs when a taller person pulls the child from above. The diagnosis is confirmed with AP and lateral radiographs of the affected limb. Magnetic resonance imaging and computed tomography are useful tools in complex elbow dislocation, since it serves to delimit the fracture or ligament injury and propose surgical management, therefore it is not the tool of choice in simple elbow dislocation. Treatment will be conservative through closed reduction and immobilization when facing a simple dislocation, or surgical management if fractures or ligament instability are associated.