Elbow Dislocation: Healing Without Surgery and Risks

Elbow dislocation without reduction and without surgery?

Hello, Doctor: I would like to ask about my right elbow.
On February 8 of this year, I was diagnosed with an elbow dislocation and a fracture below the elbow at the hospital.
I went to the emergency room because the area below my elbow was swollen to the size of a fist.
I underwent X-rays, a CT scan, an MRI, and consultations with various specialists.
I eventually had surgery to address a hematoma, which has been resolved.

The main issue now is that both orthopedic surgeons I consulted indicated that they could not intervene, while another physician suggested allowing it to heal naturally without recommending surgery or manual reduction.
I have a rare condition known as neurofibromatosis.
If no intervention is performed, will it heal on its own? How long will it take to fully heal? Is there a risk of any long-term complications? As for the fracture below my elbow, I had a follow-up appointment last week where the doctor said it has healed.
The biggest concern now is the dislocated elbow.

Xiao Feng, 30~39 year old female. Ask Date: 2021/04/09

Dr. Chen Yongxue reply Orthopedics

Hello, 1.
Nerve fiber tunnels do not affect the healing of fractures.
2.
An elbow dislocation should be reduced; if closed reduction fails, surgical reduction may be necessary.
3.
The degree of comminution in a fracture can affect the healing time, which typically requires more than six weeks.
It is advisable for you to visit an orthopedic clinic for further evaluation.
Thank you.

Reply Date: 2021/04/09

More Info

Elbow dislocation is a common injury that can occur due to trauma, such as falls or accidents. In your case, it appears that you experienced a significant injury involving both an elbow dislocation and a fracture below the elbow. The management of such injuries can vary based on the specifics of the case, including the presence of associated fractures, the degree of soft tissue injury, and any underlying conditions, such as your neurofibromatosis.

Healing Without Surgery
In many cases, elbow dislocations can heal without surgical intervention, especially if the dislocation is not associated with significant instability or complex fractures. The decision to treat conservatively (without surgery) often depends on the following factors:
1. Type of Dislocation: Simple dislocations, where the bones are not significantly displaced or associated with fractures, may heal well with conservative management. However, if there are fractures or if the dislocation is recurrent, surgical intervention may be necessary.

2. Stability of the Joint: If the elbow joint is stable after reduction (the process of putting the dislocated joint back into place), non-surgical treatment may be appropriate. Stability can be assessed through physical examination and imaging studies.

3. Underlying Conditions: Your rare condition, neurofibromatosis, may complicate the healing process. It is essential that your orthopedic team considers this when determining the best course of action.

Healing Time
The healing time for an elbow dislocation can vary widely. Generally, if treated conservatively, you can expect the following timelines:
- Initial Healing: The initial healing phase, where the soft tissues and ligaments begin to recover, typically takes about 4 to 6 weeks.

- Full Recovery: Complete recovery, including regaining full range of motion and strength, may take several months (up to 3 to 6 months) depending on the extent of the injury and your rehabilitation efforts.

Risks and Potential Complications
While many elbow dislocations heal well, there are potential risks and complications to be aware of:
1. Stiffness: One of the most common complications following an elbow dislocation is stiffness, which can result from immobilization and the injury itself. Physical therapy is often recommended to help regain motion.

2. Instability: If the ligaments around the elbow are damaged, there may be a risk of ongoing instability, which could lead to recurrent dislocations.

3. Nerve Injury: There is a risk of nerve injury, particularly to the ulnar nerve, which runs near the elbow. This can lead to symptoms such as numbness or tingling in the ring and little fingers.

4. Post-Traumatic Arthritis: Over time, joint injuries can lead to the development of arthritis, which may cause pain and limit function.

5. Delayed Healing: In some cases, especially with underlying conditions, healing may be delayed, and additional interventions may be required.

Conclusion
In summary, while it is possible for your elbow dislocation to heal without surgery, it is crucial to have regular follow-ups with your orthopedic specialist to monitor the healing process. They will assess the stability of your elbow and guide you on rehabilitation exercises to help restore function. If you experience any new symptoms, such as increased pain, swelling, or changes in sensation, you should seek medical attention promptly.

It is also advisable to discuss your specific case with your healthcare provider, who can provide personalized recommendations based on your unique medical history and current condition.

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