Posterior Elbow Dislocation The elbow is the second most commonly dislocated major joint in adults and the most common in children, 80% of elbow dislocations occur posterolateral. Here’s a quick summary. • Second most common major joint dislocation overall (most common in children) with 80% occurring posterolateral, peak age 10-20 • Named based on anatomic location of olecranon relative to humerus; simple = no fracture, complex = fracture • Mechanism: fall onto outstretched hand • Exam: swelling with obvious deformity, elbow is flexed with prominent olecranon • Possible associated injuries: Fractures (medial/lateral epicondyle > radial head > coronoid process), neuropraxia (anterior interosseous nerve [can't make A-OK sign] most common), ligamentous injury (LCL > MCL), brachial artery injury • Terrible triad = posterior dislocation + radial head fracture + coronoid process fracture • ED Management: Simple, pain control +/- procedural sedation and reduction; Complex, involve orthopedics • Splint: Posterior long arm • Ortho consult: No, if simple; Yes, if complex • Disposition: Simple, DC with ortho follow-up within 1 week; Complex, pending orthopedic recommendations MH/CCF/CWRU EM Res @MetroHealth_EM #Elbow #Dislocation #Posterior #Radiology #XRay #Diagnosis #Management #Orthopedics #Sports #MSK
