Elbow dislocation: what to do, recovery and physiotherapy

Elbow dislocation is a very common injury in the child, which occurs in the event of a fall with the 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 putting the elbow back in its anatomical position must be performed by a health professional because there may be ligament tears or nervous or vascular changes that can make it difficult to rehabilitation.

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

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

The elbow will be properly positioned when a small crack is heard, and it is 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 to the emergency room immediately, because 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 assesses neurological function and an x-ray exam, which can show the angle and severity of the dislocation.

When surgery is indicated

In the most severe cases, surgery may be indicated to properly reposition the bones of the forearm, ulna and radius, especially when it is not possible to perform the proper positioning of this joint through the abovementioned reduction, when there is bone fracture, great instability of the joint or injury of the nerve or blood vessels in the arm. Surgery can be performed as soon as possible and can be done under local anesthesia.

Recovery of elbow dislocation

In the simplest cases, when it is possible to perform the reduction with the steps above, without the need for surgery, recovery is quick and the site may be just a little sore. To relieve this inconvenience, you can place a frozen gel pack or ice pack. The ice should be applied for 15-20 minutes, without direct contact with the skin, and for that you can put a thin tissue or paper towel to protect the skin. This care can be performed 2-3 times a day.

Elbow immobilization

Elbow immobilization may be necessary in case of complete dislocation, which is usually treated by surgery. The immobilization can last 20-40 days, being necessary to complement the treatment through physiotherapy to normalize the movement of the elbow. The time of physical therapy treatment depends on the severity of the injury and age, because children recover faster, while in adults it may be necessary to invest in a few months of physical therapy.

Physiotherapy after elbow dislocation

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

In the first days after the dislocation it is recommended to perform manual techniques to increase the amplitude of the joint, and isometric exercises with the elbow bent, extended and exercises to open and close the hands, aiming at increasing the muscular strength. As resources, TENS, tourbillon, ultrasound, infrared or laser devices can be used, according to the evaluation performed by the physiotherapist.

After a few days, in the next phase of treatment, the physiotherapist can reevaluate the movement skills, angles and strength, and progress the treatment with other exercises for global stretching of the arm and hand, and exercises like wrist curls, biceps and can stick, bottles and backrest, 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 of the affected arm.

In the final treatment phase, 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.