A closed reduction of the elbow refers to putting the elbow back into place after a dislocation.
Overview of procedure
This is a non-surgical procedure accomplished by pulling down on the wrist and levering the elbow back into place by placing firm pressure on the back of the elbow. An audible “clunk” may be heard as the bone slides back into place.
Pre-treatment considerations
- Must assess if there is any compromise of any nerve or blood vessel to the hand and wrist.
- This is a very painful procedure. The patient may need pain medication, muscle relaxants, or anesthesia before reduction can be attempted.
- Must consider which direction the elbow dislocated. Most dislocations are posterior (backward) or posterior-lateral (back and toward the outside).
Post-treatment considerations and recovery
- After the elbow is back in place the physician will x-ray to make sure that there is no fracture
- Physician will then assess the stability of the reduction by putting the patient through a full range of motion exam and determine if there is any injury to other soft tissue structures
- Patient will then be placed in a 90 degree L shaped splint which will prevent movement of the elbow and placed in a sling for 5-10 days
- Surgery may be needed if the elbow is still unstable or if there is injury to other structures.
- Follow up in 3-5 days for additional x-rays and then again at 10-14 days.
- Early mobilization of simple dislocations after a closed reduction is associated with a lower risk of re-dislocation (less than 2%)
- Brace elbow for 3-4 weeks
- Return to normal activity levels 6-8 weeks after surgery.
Pros and benefits
- Structural integrity of the elbow is maintained
Cons, risks, and possible side effects
- Unable to straighten elbow all the way
- Instability of the elbow
- Nerve or blood vessel injury
- Compartment syndrome
- Stiffness in elbow
- Ossification in elbow
- Damage to articular surfaces of elbow.
