Elbow dislocation

Synonyms for elbow dislocation

• Elbow dislocation

What is an elbow dislocation?

An elbow dislocation occurs when the bones of the forearm shift out of their normal position relative to the upper arm bone following an injury. The two bones of the forearm are the ulna and the radius; the bone of the upper arm is the humerus. The elbow is then dislocated. A subluxation refers to a partial dislocation, while a complete dislocation completely separates the joint surfaces.

Most often, the forearm moves backward: the ulna and radius dislocate together from the humerus¹.

Doctors classify elbow dislocations into two types. A simple dislocation involves the ligaments—the strong bands that connect the bones—without a significant fracture. A complex dislocation combines the dislocation with a fracture^, which complicates^{treatment.², ³}

What are the causes of an elbow dislocation?

An elbow dislocation can be caused by a fall, a direct blow, or a severe twisting of the arm. Common causes include:

• A fall on an outstretched hand (the most frequent mechanism)
• A fall onto the elbow or arm
• A direct impact to the elbow (checking in hockey, tackling in football)
• An extreme twisting motion of the elbow (the arm remains locked in place while the body continues to move forward)
• When a young child has their arm pulled and then refuses to move their elbow, it may be a case of painful pronation: the head of the radius—the part of this bone located near the elbow—slips along the ligament that holds it in place. This condition is different from a complete elbow dislocation⁴. A healthcare professional should examine the child and realign the bone if this diagnosis is confirmed. Do not attempt to do this yourself.

Pain that develops gradually, without any specific injury, is less likely to be caused by a recent dislocation. An examination is still warranted if the elbow appears to be misaligned or does not function properly.

What are the symptoms of an elbow dislocation?

An elbow dislocation usually causes sudden pain, difficulty moving the arm, and sometimes visible deformity.

The main signs include:

• Elbow pain that develops quickly after the injury and an inability to move the arm as usual
• Feeling that the elbow has popped out of place
• Deformation of the elbow compared to the other one

There may or may not be swelling and a bruise (ecchymosis).

When should you go to the emergency room after a dislocated elbow?

A possible elbow dislocation requires immediate evaluation in the emergency room, even if there is no numbness or change in skin color. Certain signs may indicate nerve or circulatory involvement and must be reported immediately (signs and management of a dislocation). Do not wait to see if they persist:

• Numbness in the arm or hand
• A loss of sensation in the arm or hand
• Cold, pale, or bluish hands or fingers, which may indicate poor blood circulation
• An inability to move the hand or fingers

How is an elbow dislocation diagnosed?

The doctor diagnoses the dislocation by examining the arm and checking the position of the bones on an X-ray. He or she will ask you how the injury occurred, then check for sensation, range of motion, and circulation in the hand.

How does the doctor put the elbow back in place?

The doctor realigns the bones using a procedure called reduction. Pain medication and, often, medication to relax you or put you to sleep briefly make the procedure easier. Local or regional anesthesia may alsobe used to numb the area, depending on the situation (to relieve pain during the realignment). The doctor then checks the elbow’s stability. A temporary brace is applied, followed by gradual movement as soon as the injury allows. Surgery may be necessary if the elbow remains unstable or if associated fractures need to be repaired.⁵

If you think you have a dislocation, go to the emergency room first. X-rays and a physical exam are performed, in part, to check for an associated fracture. Do not attempt to put the elbow back in place, and do not force it to move (first aid for a dislocated joint).

When to consult in physiotherapy for an elbow dislocation?

Physical therapy begins after the elbow has been reduced, according to the schedule and range of motion authorized by the doctor. The doctor will establish a rehabilitation plan and may refer you to a physical therapist to help you gradually resume your activities.

For a simple, stable dislocation, resuming movement early promotes faster recovery than prolonged immobilization. In a trial involving 100 adults, early movement was compared to three weeks in a cast. At six weeks, participants had less difficulty using their arms and were able to bend and straighten their elbows more fully. The results were similar at one year. The return to work was faster—10 days versus 18 days⁶. The program then progresses to strengthening exercises as recovery allows. This final phase is part of the care described in patient recommendations, but the trial does not allow for isolating its effect or promising a faster return to sports.

How should we organize the start of the sessions?

• If no immobilization is prescribed, begin the sessions as soon as the medical team authorizes movement.
• If you are wearing a cast or splint—a device that supports your arm—your physical therapist can provide guidance while taking these restrictions into account. Pain that worsens along with a feeling that the cast is too tight, numbness, a burning sensation, or excessive swelling beyond the cast—for example, in your fingers—requires immediate medical attention. Inability to move your fingers requires an urgent evaluation (signs to watch for under a cast or splint).
• Even if you are not experiencing any pain, be sure to keep the cast or splint on for the prescribed duration. Schedule your physical therapy appointments as directed, and do not remove the cast or splint on your own.

If you're not sure when to start, ask your doctor or physical therapist to outline a schedule. The physical therapist can help you stick to the plan and refer you to your doctor if further testing is needed.

What are the physiotherapy treatments for an elbow dislocation?

Physical therapy uses gradual movements, exercises, and guidance to help you regain mobility, strength, and function in your elbow. The physical therapist begins by assessing what you can do and what remains difficult:

• Your ability to bend, straighten, and rotate your elbow
• Sensitivity in the hand and symptoms caused by movement: the nerves that pass through the elbow may be affected by the injury.
• The quality of your movements
• Your strength and the elbow's ability to remain stable during permitted movements

What treatments might be included in the treatment plan?

Based on the assessment and medical instructions, the physical therapist may:

• Gently guide the elbow's movements with your hands to help relieve pain and restore range of motion
• To teach you exercises to help you regain:
  
  • Controlling elbow movements
  • Elbow stability and strength
  • Elbow mobility
• To provide you with exercises designed to reduce pain
• To teach you how to adjust the duration, intensity, and frequency of your activities and hobbies during recovery
• To advise you on the positions and movements that make your activities easier.

What to do at home for an elbow dislocation?

Home care involves protecting the elbow and performing only the movements authorized by the medical team. If the elbow has just dislocated and has not yet been examined, support the arm in the most comfortable position during the trip to the hospital. A sling or triangular bandage can provide support, without forcing the hand against the abdomen or attempting to realign the bones (protect a dislocated joint). After treatment, follow the prescribed immobilization period. If there is also a fracture, the restrictions may differ.

Prolonged immobilization can slow the return of movement. In a study of 50 people, early movement led to better recovery of extension—that is, the ability to straighten the elbow—than three weeks in a cast. Stiffness affected 4% of the group that began moving early, compared with 19% of the immobilized group. The study also measured pain but did not show a clear enough difference to conclude that one group had an advantage over the other⁷. However, a review of several studies found less pain and a faster return to activities with treatment that encourages early movement (treatment review). These results support a guided return to activity; they do not justify removing a prescribed brace on your own.

How can you make resting positions more comfortable?

After the elbow has been reset, follow these guidelines in accordance with the prescribed precautions:

• Support the arm with a pillow or armrest, without changing the angle set by the splint. If movement is allowed and this position is comfortable, you can also support the arm by placing your hand in your pants pocket.
• If you experience pain at night or stiffness when you wake up, make sure your neck is properly supported by a comfortable pillow. Avoid sleeping with your arm behind your head or under the pillow. Support your arm with a pillow or keep it close to your body, depending on the instructions you’ve received.
• Avoid sleeping on the affected side.

How does recovery progress after an elbow dislocation?

A simple elbow dislocation generally heals well after reduction and appropriate care. The patient information sheet on elbow dislocation describes typically favorable outcomes, while noting that some people may continue to have difficulty fully extending their arm. Treatment that encourages early movement generally yields better results than prolonged use of a cast³. A publication on the management of dislocations reports stiffness in up to 40% of patients and recurrent instability—when the elbow dislocates again—in up to 10%¹. These rates vary depending on the specific injuries and the populations studied.

After a dislocation, the elbow may remain less stable. Osteoarthritis—a condition that affects the joint and can cause pain and stiffness—may also develop. An earlier study followed 41 people for an average of nine years after three weeks in a cast. X-rays taken while applying force to the elbow showed signs of instability in 24 people—about 59 percent—and changes in the joint in 21 people—about 51 percent⁸. Most, however, described the function of their elbow as good or excellent. These radiographic signs are not the same as a new episode of dislocation. They do not necessarily reflect the results of current treatment approaches that resume movement early.

Who is most likely to experience an elbow dislocation?

Teenagers and young adults are particularly prone to elbow dislocations, which often occur during sports or recreational activities.

• The elbow is, after the shoulder, the second most commonly dislocated major joint in adults²
• Elbow dislocations most commonly affect adolescents and young^{adults9, 10}
• Elbow dislocations are common among young people: adolescents aged 10 to 19 have the highest rate among the age groups studied⁹, and another population-based study also found the highest prevalence among the youngest participants¹¹. These results describe the frequency of elbow dislocations by age.
• In an American population-based study, the rates were nearly identical among men and women: the ratio was 1.02⁹, and another study found no clear difference between the sexes¹¹. Among people aged 10 to 39, however, a study published in 2026 observed a higher rate among men; sports and recreational activities were the predominant circumstances in this group¹⁰.
• In the studies cited, the incidence generally decreases after adolescence, but dislocation remains possible at any age.
• Sports associated with these injuries include soccer, wrestling, basketball, gymnastics, and skating, according to the U.S. population-based study⁹. The chapter on elbow dislocation also mentions roller skating and skateboarding. A study conducted in U.S. high schools found that dislocations occurred most frequently in wrestling and football among boys¹². These circumstances vary depending on the sports played in each population.

Sources

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