A Novel Reduction Technique for Elbow

Elbow dislocations are a common orthopedic injury, but the ideal reduction method remains elusive. The complex trochoginglymus anatomy of the joint, along with the close proximity to neurovascular structures, makes the elbow a challenge to reduce. Elbow dislocations occur at a rate of approximately 6 to 8 cases per 100,000 individuals and account for 10% to 25% of all elbow injuries annually.1 The elbow’s motion and structure predispose it to posterior dislocation with an axial force. The articular surfaces are largely apposed by ligament and muscular attachments.2 As a result, the elbow is the second most commonly dislocated joint after the shoulder.1 Most commonly, the elbow is dislocated in a posterolateral direction. As with all dislocations, prompt relocation is critical to minimize injury to the joint and preserve function in the long-term. Several different techniques have been described for the reduction of a posterior dislocation; however, most methods require special positioning,3-5 sedation,6 countertraction,1,7 trained assistants,1,7 and additional equipment.3-5 These methods are also based around pulling or pushing the elbow into position, while a few methods use a fulcrum to facilitate the reduction.3,8 The authors present a method that does not require special equipment, unique positioning, anesthesia, or assistants. The novel technique is performed by a single person using his or her own elbow as a fulcrum and opposite hand as a means to distract and rotate the patient’s forearm to reduce the elbow. No nerve, vascular, or iatrogenic fractures were associated with this elbow reduction technique in the current series, and it can be performed without assistance.