Elbow dislocation: what to do, recovery and physical therapy

Elbow dislocation is a very common injury in children, which occurs in the event of a fall with arms outstretched or when the child is suspended by just one arm, for example.

Elbow dislocation can also happen in athletes during training or competition, and the act of placing the elbow back in its anatomical position must be carried out by a healthcare professional because there may be ligament tears or nervous or vascular changes that can make it difficult. rehabilitation.

The steps that the healthcare professional can take to reduce elbow dislocation may be:

1. Hold the child’s arm with the palm facing down,
2. Hold the arm and forearm at the same time and pull them slightly in opposite directions to create space in the joint,
3. Position the child’s hand facing upwards and at the same time bend the elbow.

The elbow will be properly positioned when a small click is heard, making it possible to move the arm normally.

In any case, when you are not sure about the type of injury, the safest thing is to take the victim immediately to the emergency room, as it is necessary to palpate the ends of the bones of the arm and elbow, in addition to tests that evaluate the ligaments. , the test that evaluates neurological function and an x-ray examination, which can highlight the angle and severity of the dislocation.

When surgery is indicated

In more serious cases, surgery may be indicated to adequately reposition the bones of the forearm, ulna and radius, especially when it is not possible to achieve adequate positioning of this joint through the reduction mentioned above, when there is a bone fracture, great instability of the joint or injury to the nerve or blood vessels in the arm. The surgery can be performed as soon as possible and can be done under local anesthesia.

Recovery from elbow dislocation

In the simplest cases, when it is possible to perform reduction using the steps above, without the need for surgery, recovery is quick and the area may only be a little sore. To alleviate this discomfort, you can apply a frozen gel compress or ice pack. The ice should be applied for 15-20 minutes, without direct contact with the skin, and for this you can place a thin tissue or paper towel to protect the skin. This care can be carried out 2-3 times a day.

Elbow immobilization

There may be a need for immobilization of the elbow in case of complete dislocation, which is normally treated through surgery. Immobilization can last 20-40 days, and it is necessary to complement the treatment with physiotherapy to normalize elbow movement. Physiotherapy treatment time depends on the severity of the injury and age, because children recover faster, while adults may need to invest in a few months of physiotherapy.

Physiotherapy after elbow dislocation

Physiotherapy may be indicated to control inflammation, reduce swelling, facilitate healing, prevent contractures, maintain range of motion and return to usual activities, without any pain or limitation of movement.

In the first few days after the dislocation, it is recommended to perform manual techniques to increase the range of motion of the joint, and isometric exercises with the elbow bent, extended and exercises to open and close the hands, aiming to increase muscle strength. TENS, whirlwind, ultrasound, infrared or laser devices can be used as resources, according to the assessment carried out by the physiotherapist.

After a few days, in the next phase of treatment, the physiotherapist can reassess the movement capabilities, angles and strength, and progress the treatment with other global stretching exercises for the arm and hand, and exercises such as wrist curls, biceps curls and can the stick, bottles and backrest can be used, for example. Shoulder exercises and postural re-education are also recommended because it is common for one shoulder to be higher than the other, due to a protective mechanism for the affected arm.

In the final phase of treatment, when referring to the athlete, it is still necessary to carry out training with exercises that can facilitate the performance of their training, according to the needs of each sport.