A dislocated elbow occurs when the bones that form the joint—the humerus, radius, and ulna—are forced out of their normal alignment, typically after a fall onto an outstretched hand or a high-impact injury. This is a serious injury that causes intense pain, obvious deformity, and an inability to move the arm. Because of the severity and the risk of associated damage to nerves and blood vessels, a dislocated elbow requires immediate professional medical attention. The treatment process is structured, moving from immediate stabilization to medical realignment and, finally, a focused rehabilitation program.
Immediate First Aid Steps
Recognizing the signs of a dislocated elbow include a visibly crooked or deformed arm and severe pain. The injured person will likely be unable to bend or straighten the arm, and they may experience numbness or tingling in the fingers if nerves are affected. The most important action before medical help arrives is to stabilize the joint exactly in the position it was found.
Never attempt to move, straighten, or manipulate the elbow back into place, as this can cause further damage to surrounding ligaments, nerves, or arteries. Using a simple splint or a sling can help keep the arm still and prevent involuntary movements during transport. Gently apply an ice pack to the area to reduce swelling and manage pain.
While waiting for transport, remove any watches or bracelets from the injured arm, as swelling may rapidly increase. This step is important because medical staff must check circulation and nerve function immediately upon arrival at the hospital.
The Process of Medical Reduction
Upon arrival at the hospital, the priority is to confirm the injury and rule out associated complications before attempting realignment. Initial X-rays confirm the dislocation and check for accompanying fractures, which would classify the injury as complex. Doctors also assess the neurovascular status of the arm, checking pulses and nerve sensation to rule out damage to the brachial artery or median and ulnar nerves.
The procedure to restore the joint’s alignment is called a closed reduction, performed under strong pain medication and often procedural sedation or general anesthesia. Sedation is necessary because surrounding muscles spasm and resist movement, and the procedure is painful. Relaxing the muscles makes the manipulation gentler and safer for the patient.
A trained physician performs the reduction maneuver by gently applying traction to the forearm while manipulating the joint to guide the bones back into their correct position. A successful reduction is often signaled by a palpable “clunk” as the bones seat themselves, and the arm may visibly lengthen. Immediately after the reduction, a second set of X-rays confirms proper alignment and ensures the joint is stable.
Recovery and Rehabilitation
Following a successful reduction, the elbow is immobilized in a splint or sling, typically bent to about 90 degrees, for a short period. This phase is generally brief, lasting one to three weeks for simple dislocations, specifically to avoid the severe stiffness that develops quickly in the elbow joint. Prolonged immobilization can severely affect the long-term ability to fully move the elbow.
Physical therapy is the most impactful part of recovery and should begin as soon as the doctor clears the joint for movement. Early, gentle range-of-motion exercises are crucial to regain flexibility and prevent long-term stiffness. A therapist guides the patient through exercises like pendulum swings and controlled flexion and extension, focusing on restoring movement without risking re-dislocation.
As mobility improves, the rehabilitation program progresses to strengthening exercises to rebuild the surrounding muscles. This includes isometric exercises and later, resistance band or light dumbbell work to enhance joint stability. A full recovery can take anywhere from six weeks for mild cases to several months for more complex injuries, though function is usually excellent even if complete range of motion is not regained.