Best Practice Case Studies-Study Questions (MY ELBOW HURTS AND MY ARM LOOKS SHORTER)

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Case Study Question #1 explores the reduction of an elbow joint, emphasizing the steps necessary to correct dislocation. The recommended procedure involves the following: 

1. <strong>Supination of the Forearm</strong>: Begin by rotating the forearm so the palm faces upward.
   
2. <strong>Elbow Flexion</strong>: Bend the elbow to recreate the typical injury position, often enacted by supination and applying a valgus stress.

3. <strong>Counter Traction on the Humerus</strong>: Stabilize the upper arm by applying a force, ensuring it remains in place during the maneuver.

4. <strong>Gentle Axial Traction on the Forearm</strong>: Apply a gentle pulling force along the forearm’s length to assist in realigning the joint.

This procedure is structured to mimic the original dislocation mechanism, facilitating a smoother reduction. As the elbow begins to realign, further elbow flexion and volar-directed pressure on the olecranon (the elbow’s bony tip) may aid the process.

In situations where the dislocation is resistant or complex, prompt orthopedic consultation is vital to prevent further damage or fracture during repeated reduction attempts. After successful reduction, the forearm should be turned so the palm faces downward (pronation) and immobilized at a 90-degree flexion angle. It's critical to reassess the distal neurovascular integrity to ensure no nerve or blood vessel damage occurred during the maneuver.

Radiographs should follow to exclude any associated fractures or intraarticular fragments. Initial treatment involves immobilizing the elbow in a posterior splint for seven to ten days, followed by reevaluation and possibly repeated imaging to confirm healing progress. This systematic approach ensures careful management and effective recovery from an elbow dislocation.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 16

Topic Elbow and Forearm

Keywords

elbow joint reduction

dislocation correction

supination

elbow flexion

counter traction

axial traction

orthopedic consultation

neurovascular integrity

radiographs

posterior splint

3rd Edition

3rd Edition, CASE 16

Elbow and Forearm