injuries poisoning
Elbow Dislocations
Treatment of Elbow Dislocations
Traction to reduce the elbow joint, usually with procedural sedation For elbow dislocations, reduction is usually with sustained, gentle traction and correction of deformity after patients are sedated and given analgesics (see How To Reduce a Posterior Elbow Dislocation ). The following technique is commonly used: With the patient supine, the practitioner flexes the elbow to about 90° and supinates the forearm. An assistant stabilizes the upper arm against the stretcher. The practitioner grasps the wrist and applies slow, steady axial traction to the forearm while keeping the elbow flexed and the forearm supinated. Traction is maintained until the dislocation is reduced. After reduction, the practitioner checks the elbow for stability by fully flexing and extending the elbow while pronating and supinating the forearm. These movements should be easy after reduction. After reduction, an x-ray should be taken to make sure no fractures were missed. The joint is immobilized. If the joint is stable, immobilization is with a sling, and range-of-motion exercises begin 1 week later. If the joint has laxity, immobilization is with a splint; the patient follows up with an orthopedic surgeon, who determines further management, including when to begin range-of-motion exercises. 