Recurrent Dislocation Of Elbow

In few case the dislocation of elbow might tend to become recurrent. It can either be acute or chronic.

Acute Recurrent Dislocation

This usually occurs when elbow suffers a serious trauma. This can occur in either of following situations

• Both radial head and coronoid process are fractured
• Extensively displaced dislocation  resulting in soft tissue incompetency

If it is due to soft tissue incompetency, the recurrence of the dislocation can be prevented by incrasng the flexion of the elbow when given  a supporting splint and increasing the duration of the splint. Increased duration helps to regain the muscle tension and competence back.

In such cases, after a period of adequate rest, the limb should be extended slowly and incrementally. This can be easilyachieved by using a hinged locking brace. During the first few days, redislocation can easily occur.

In follow upof these patients an extra caution should be takenwhile mobilising themand one should be alert enough to recognize the signs of redislocation.

In cases of fractures of coronoid and olecronon, the appropriate surgical fixation would provide the required stabilisation of elbow to prevent redislocation. It may also be helpful to repair or reconstruct the medial and lateral ligaments.

To stabilize the joint per se, the choice of implant depends on the surgeon, expertise and availability of the implant. Whenever feasible, hinged external fixator is the treatment of choice.

Chronic Recurrent Dislocation

Chronic instability of the elbow leading to recurrent dislocation was thought to be rare but is increasingly being reported now. T problem with recurrent dislolocation of elbow is that the diagnosis is often difficult to make and may go unnoticed for some time.

It occurs more commonly in young athletes.

Reasons for chronic recurrent dislocation are

• Joint Laxity
• Break in capsule
• Coronoid fracture

The treatment includes the repair of the defect. These patients should be  rehabilitated very slowly and supination should be limited inearly stages.