Elbow Dislocation Recovery: Timeline and Rehabilitation Concerns

Elbow dislocation

Hello, doctor.
I dislocated my left elbow due to a car accident and underwent surgical reduction that same night.
The incident occurred on July 17, and I was placed in a fiberglass cast.
I returned for a follow-up on July 21, and the doctor mentioned that the X-ray looked promising for recovery.
The cast was removed, and I was fitted with a dynamic splint (the type that allows for adjustable angles), currently set at 90 degrees.
The doctor from Cathay stated that I should maintain this position for two weeks, after which I can gradually increase the angle.
I am scheduled for another X-ray follow-up in a month.
I have two questions: 1.
Should the "two weeks" be counted from July 17 or July 21? Will maintaining the 90-degree position for these two weeks lead to adhesions? 2.
It seems that I won't be able to start rehabilitation until a month later.
Is this duration too long? I am very concerned about potential long-term effects on my elbow, particularly the inability to fully extend it, so I would appreciate your opinion.
Thank you.

birdism, 30~39 year old female. Ask Date: 2015/07/22

Dr. Shi Guozheng reply Orthopedics

Typically, after an elbow dislocation, immobilization should last about four to six weeks.
Prolonged immobilization can lead to the inability to fully extend the joint.
Therefore, it is advisable to remove the cast and begin rehabilitation before six weeks.
Of course, if the joint is stable, it is also acceptable to start some light activities after four weeks, but this must be confirmed by a physician's examination.

Reply Date: 2015/07/22

More Info

Elbow dislocation recovery can be a complex process, and your concerns are quite valid. Based on your description, it seems you are currently in the early stages of recovery following a dislocated elbow due to a car accident, which required surgical intervention. Let's address your questions and provide some additional insights into the recovery timeline and rehabilitation process.

1. Timeline for Maintaining 90 Degrees: When your doctor mentioned maintaining the elbow at 90 degrees for two weeks, this typically refers to the time frame starting from the date of your surgery, which is July 17. Therefore, you should aim to keep your elbow at this angle until approximately July 31. The purpose of maintaining this position is to allow the ligaments and surrounding tissues to heal properly without excessive strain.
As for your concern about adhesions (or "stiffness") forming during this period, it is a common worry. However, keeping the elbow at 90 degrees is a standard practice to ensure stability while healing. To mitigate the risk of stiffness, your healthcare provider may recommend gentle range-of-motion exercises once you are cleared to do so, typically after the initial immobilization period.

2. Rehabilitation Timeline: You mentioned that you would be returning for a follow-up X-ray in one month. While it may seem like a long time to wait before starting rehabilitation, this approach is often necessary to ensure that the joint has healed sufficiently before beginning more aggressive therapy. The one-month mark is a common time frame for assessing the healing process after an elbow dislocation.
After the initial immobilization phase, rehabilitation typically begins with gentle range-of-motion exercises. The goal is to gradually restore flexibility and strength to the elbow joint. Depending on the healing observed in your follow-up X-ray, your doctor may adjust your rehabilitation plan accordingly.
It is important to note that every individual’s recovery timeline can vary based on the severity of the dislocation, the surgical technique used, and your overall health. While some patients may start rehabilitation sooner, others may need to wait longer to ensure optimal recovery.

Additional Considerations:
- Potential for Complications: After an elbow dislocation, there is a risk of complications such as stiffness, loss of range of motion, or even nerve damage. Regular follow-ups with your orthopedic surgeon are crucial to monitor your recovery and address any concerns early on.

- Physical Therapy: Once you begin rehabilitation, working with a physical therapist can be incredibly beneficial. They can provide tailored exercises to help improve your range of motion and strength while minimizing the risk of complications.
- Home Exercises: Depending on your doctor’s advice, you may be able to perform some gentle home exercises even during the immobilization phase. These could include wrist and finger movements to maintain circulation and prevent stiffness in the forearm and hand.

- Long-term Outlook: Most patients can expect to regain a significant range of motion and function in their elbow following proper rehabilitation. However, it is essential to be patient and adhere to your rehabilitation plan to achieve the best possible outcome.

In summary, while the timeline for recovery may seem lengthy, it is designed to ensure that your elbow heals correctly. Maintaining the prescribed angle and following up with your healthcare provider will help minimize the risk of complications and promote a successful recovery. If you have any further concerns or questions, do not hesitate to reach out to your healthcare team for personalized advice.

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