Elbow dislocations occur if the inferior end of the upper arm bone loses connection with the head of the forearm bones (radius and ulna). The injury can be categorized as complete or partial (subluxation).
The complete elbow dislocations are uncommon and typically result from significant force. As for a partial dislocation, they are common among toddlers and typically result from minimal force.
What are the indications?
The joint might only be mildly tender. Since toddlers could not describe the symptoms, the only indication of this injury might be unwillingness to move the arm. The arm might dangle down by the side of the body which oftentimes turn slightly inward.
Toddlers might hold the arm in a bent position against the body. It is not recommended to move the arm. Take note that toddlers might cry when the injury occurs but calm down and continue to act normally except that they do not use the affected arm.
Diagnosing elbow dislocations
If a toddler has no symptoms that indicates an elbow subluxation, parents should bring the child to a doctor even if the elbow slides back into its place on its own.
The doctor will suspect this injury based on the description of how it occurred, the ensuing symptoms and results of the physical exam. An X-ray will not reveal the injury which is why it is not done.
Prevention
There are measures that can prevent elbow subluxation among toddlers such as the following:
- Avoid sudden jerking of the wrist, hand or forearm
- Avoid lifting toddlers by one arm, hand or wrist only
- Do not swing children by their forearm or hand
- Lift toddlers from under the arms or from both arms
Treatment
The doctor will attempt to position the joint back in place. In most instances, no pain medication or sedatives are needed. When the bone slips back in place, a soft click or pop can be heard.
A toddler might move the affected elbow after 10-20 minutes. If he/she will not move it, the doctor will take an X-ray of the elbow. If the toddler was able to move the joint, immobilization is not required.
In case after 24 hours the toddler continues to experience pain or he/she could not use the arm, the joint might not be fully in place or there is a bone fracture. In such instances, the toddler should be assessed by the doctor again.
With proper treatment, most are able to recover completely. Nevertheless, 20-40% of these children might dislocate the elbow again.