Dislocation
Hello, I dislocated my right elbow completely on March 16 (without fractures).
After two weeks in a cast, I was unable to achieve more than 90 degrees of joint movement (while the normal range is about 135 degrees).
After a month of traditional Chinese medicine rehabilitation, I hit a plateau and am now seeking treatment at a Western medicine rehabilitation clinic (three times a week), where I am undergoing hydrotherapy, electrical stimulation, and manual therapy.
Currently, I cannot fully extend my arm (about 30 degrees short) and my flexion is slightly less than 90 degrees.
Initially, when the injury was treated, the orthopedic doctor did not attempt to mobilize my joint before applying the cast.
However, after consulting with an orthopedic surgeon, a rehabilitation specialist, and a traditional Chinese medicine doctor, they all indicated that the X-rays show the joint has healed after four months.
I would like to know if my recovery is too slow and if there is a need for surgery.
Thank you.
A-Hsing, 20~29 year old female. Ask Date: 2004/08/02
Dr. Zhou Lizhi reply Orthopedics
Regarding elbow dislocation, it primarily depends on the severity of the injury, which can be classified into simple dislocation and complex dislocation (including fractures).
In the case of a simple dislocation, after reduction, if stability is achieved, a sling can be used for immobilization.
After one week of observation, the patient can resume activities.
On the other hand, complex dislocations (or those with fractures) are characterized by joint instability, making them prone to recurrent dislocation.
These often require treatment with a cast, with the optimal immobilization angle being between 90 to 120 degrees.
This angle is important as poor blood circulation can lead to swelling and discomfort.
The most significant complication of complex dislocation is joint stiffness, resulting in limited range of motion.
For younger individuals, early and aggressive rehabilitation treatment is essential, but the extent of fracture healing must also be considered.
If there are further questions, individuals can visit an orthopedic clinic for X-ray examinations and physical assessments to evaluate the recovery status.
Reply Date: 2004/08/02
More Info
Hello! It sounds like you’ve been through quite a journey with your elbow dislocation, and I understand your concerns about your recovery process. Let’s break down your situation and discuss what you might expect moving forward.
When it comes to elbow dislocations, recovery can vary significantly from person to person. The fact that you had a complete dislocation without any fractures is a positive sign, as fractures can complicate recovery. However, even without fractures, the elbow joint is complex, and regaining full range of motion can take time.
After a dislocation, it’s common to experience stiffness and limited range of motion, especially if the joint was immobilized for an extended period. The typical recovery timeline for elbow dislocations can range from a few weeks to several months, depending on various factors such as the severity of the dislocation, the effectiveness of rehabilitation, and individual healing rates.
You mentioned that you are currently unable to fully extend your elbow and that you have reached a plateau in your recovery. This is not uncommon. Many patients experience a phase where progress seems to stall, which can be frustrating. The fact that you are now seeking treatment from a physical rehabilitation clinic is a positive step. Physical therapy is crucial in regaining strength and mobility after an elbow dislocation.
In terms of your current range of motion, achieving 90 degrees of flexion is a good start, but as you noted, full extension and further flexion are still lacking. The goal is to gradually improve your range of motion through consistent therapy. Techniques such as manual therapy, stretching exercises, and modalities like electrical stimulation can help facilitate recovery.
As for your concern about whether you are recovering too slowly, it’s important to remember that everyone heals at their own pace. Factors such as age, overall health, and adherence to rehabilitation protocols can all influence recovery time. If your elbow has been stable on X-rays and there are no signs of complications, it’s likely that your current recovery is within a normal range, albeit on the slower side.
Regarding the possibility of needing surgery, this is typically considered if there are signs of persistent instability, significant loss of motion that does not improve with conservative treatment, or if there are underlying issues that were not addressed initially. If your elbow joint is stable and your X-rays look good, surgery may not be necessary. However, if you continue to experience significant limitations or pain, it would be wise to discuss this with your orthopedic surgeon. They may recommend further imaging or evaluation to determine if there are any underlying issues that need to be addressed surgically.
In summary, continue with your physical therapy, stay consistent with your exercises, and communicate openly with your healthcare providers about your progress and concerns. If you feel that your recovery is not progressing as it should, don’t hesitate to seek a second opinion or further evaluation. Remember, recovery from an elbow dislocation can take time, but with the right approach, you can achieve significant improvements. Best of luck with your rehabilitation!
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