Forearm dislocation: causes, symptoms, diagnosis, treatment

ICD-10 code

S53. Dislocation, sprain and injury of the capsular-ligamentous apparatus of the elbow joint.

Epidemiology of forearm dislocation

Forearm dislocations account for 18-27% of all dislocations.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Posterior dislocation of both bones of the forearm

ICD-10 code

S53.1. Dislocation of elbow joint, unspecified.

Epidemiology

Posterior dislocation of both forearm bones accounts for about 90% of all elbow joint dislocations. Posterior dislocation of both forearm bones is the result of an indirect mechanism of injury - a fall on an outstretched arm with hyperextension of the elbow joint.

[ 5 ], [ 6 ], [ 7 ]

Symptoms of a Forearm Dislocation

The victim is concerned about pain and dysfunction in the elbow joint that followed the injury.

Classification of forearm dislocation

In the elbow joint, simultaneous dislocation of both bones is possible, as well as isolated dislocation of the radius and ulna. Depending on this, the following types of forearm dislocations are distinguished.

• Dislocation of both bones of the forearm backwards, forwards, outwards, inwards and divergent dislocation.
• Dislocation of the radius bone anteriorly, posteriorly, and laterally.
• Dislocation of the ulna.

Indications for hospitalization

Among all types of elbow joint congruence disorders, the most common are posterior dislocation of both forearm bones and anterior subluxation of the radial head in children. These two nosological entities are subject to outpatient treatment. Other types of dislocations are rare. Their treatment involves general anesthesia and other difficulties, so patients should be referred to the emergency hospital for assistance.

[ 8 ], [ 9 ], [ 10 ], [ 11 ]

Diagnosis of forearm dislocation

History of the corresponding injury. The joint is swollen, deformed. On the back surface, at some distance from the shoulder, the olecranon protrudes under the skin. The triangle and Huther's line are damaged. The forearm is shortened. Active and passive movements in the elbow joint are absent. An attempt to perform them causes acute pain. A positive symptom of springy resistance is noted.

Laboratory and instrumental studies

Radiographs taken in two projections reveal separation of the articulating surfaces of the shoulder and forearm.

To clarify the diagnosis, it is necessary to check the motor function and cutaneous sensitivity in the innervation zone of the ulnar, radial and median nerves.

[ 12 ], [ 13 ], [ 14 ], [ 15 ]

Treatment of forearm dislocation

The forearm is repositioned under general or local anesthesia. The arm is abducted and slightly straightened at the elbow joint. The surgeon grasps the victim's shoulder in the lower third with both hands so that the thumbs rest on the protruding olecranon.

The assistant holds the hand. Traction is applied along the axis of the limb, and the surgeon uses his thumbs to move the olecranon and the head of the radius forward while simultaneously pulling the humerus backward and using it as a support point. If the forearm is repositioned, free passive movements appear.

It is necessary to recognize the incorrect method of reducing a posterior dislocation of the forearm with the elbow joint bent to an angle of 90°, since this can result in a fracture of the coronoid process.

The limb is fixed with a posterior plaster splint from the upper third of the shoulder to the heads of the metacarpal bones. X-ray control is mandatory. The immobilization period is 5-10 days. Then rehabilitation treatment is prescribed: exercise therapy, physiotherapy, hydrotherapy. In the early stages of treatment, elbow joint massage, mechanotherapy, forced passive movements should not be prescribed, since they become rough irritants and increase ossification of periarticular tissues.

Approximate period of incapacity

Working capacity is restored within 6-8 weeks.

[ 16 ], [ 17 ]