Skip to main content
Journal of Athletic Training logoLink to Journal of Athletic Training
. 2000 Jan-Mar;35(1):108–110.

Rehabilitation After Posterolateral Dislocation of the Elbow in a Collegiate Football Player: A Case Report

Tim L Uhl *, Michelle Gould , Joe H Gieck
PMCID: PMC1323450  PMID: 16558601

Abstract

Objective:

To describe a functional rehabilitation program for a football player with a grade 2 posterolateral elbow dislocation to facilitate early return to competition.

Background:

Conservative management of a posterior dislocation of the elbow is common. The elbow is the second most frequently dislocated large joint in adults. Two common mechanisms of dislocation are hyperextension and posterolateral rotation. Prolonged immobilization can be detrimental to regaining full range of motion and function of the elbow, whereas early directed rehabilitation may lead to early return to normal function.

Differential Diagnosis:

Elbow dislocation with medial collateral ligament rupture, elbow subluxation, elbow dislocation with neurovascular compromise, or supracondylar fracture.

Treatment:

The athlete received immediate care of reduction and immobilization in a 90° posterior splint followed by a radiologic evaluation. Postreduction treatment included a short immobilization period and early initiation of protected active and resistive range-of-motion exercises. The athlete was able to return to full football activities in 3 weeks. He competed for the rest of the season with the elbow braced and taped, with no recurring incidents of instability.

Uniqueness:

The time to return to full participation was rapid. The medial collateral ligament was intact, as determined by magnetic resonance imaging. The athlete has since been followed for 2 football seasons and has not demonstrated any detrimental effects due to his early return.

Conclusions:

Early determination of the status of the medial collateral ligament through physical examination or imaging combined with early directed rehabilitation of a posterolateral elbow instability enabled this athlete to respond well. He regained pain-free full range of motion, strength, and function, allowing full participation in football at the Division I level with no recurring incidence of dislocation.

Keywords: posterior elbow dislocation, football injury, elbow bracing

Full text

PDF
108

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Dürig M., Müller W., Rüedi T. P., Gauer E. F. The operative treatment of elbow dislocation in the adult. J Bone Joint Surg Am. 1979 Mar;61(2):239–244. [PubMed] [Google Scholar]
  2. GRANT A. E. MASSAGE WITH ICE (CRYOKINETICS) IN THE TREATMENT OF PAINFUL CONDITIONS OF THE MUSCULOSKELETAL SYSTEM. Arch Phys Med Rehabil. 1964 May;45:233–238. [PubMed] [Google Scholar]
  3. Hassmann G. C., Brunn F., Neer C. S., 2nd Recurrent dislocation of the elbow. J Bone Joint Surg Am. 1975 Dec;57(8):1080–1084. [PubMed] [Google Scholar]
  4. Josefsson P. O., Gentz C. F., Johnell O., Wendeberg B. Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. A prospective randomized study. J Bone Joint Surg Am. 1987 Apr;69(4):605–608. [PubMed] [Google Scholar]
  5. Josefsson P. O., Johnell O., Wendeberg B. Ligamentous injuries in dislocations of the elbow joint. Clin Orthop Relat Res. 1987 Aug;(221):221–225. [PubMed] [Google Scholar]
  6. Josefsson P. O., Nilsson B. E. Incidence of elbow dislocation. Acta Orthop Scand. 1986 Dec;57(6):537–538. doi: 10.3109/17453678609014788. [DOI] [PubMed] [Google Scholar]
  7. Linscheid R. L., Wheeler D. K. Elbow dislocations. JAMA. 1965 Dec 13;194(11):1171–1176. [PubMed] [Google Scholar]
  8. Mehlhoff T. L., Noble P. C., Bennett J. B., Tullos H. S. Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg Am. 1988 Feb;70(2):244–249. [PubMed] [Google Scholar]
  9. Morrey B. F., An K. N. Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med. 1983 Sep-Oct;11(5):315–319. doi: 10.1177/036354658301100506. [DOI] [PubMed] [Google Scholar]
  10. Morrey B. F., Tanaka S., An K. N. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res. 1991 Apr;(265):187–195. [PubMed] [Google Scholar]
  11. Neviaser J. S., Wickstrom J. K. Dislocation of the elbow: a retrospective study of 115 patients. South Med J. 1977 Feb;70(2):172–173. doi: 10.1097/00007611-197702000-00013. [DOI] [PubMed] [Google Scholar]
  12. O'Driscoll S. W. Elbow instability. Hand Clin. 1994 Aug;10(3):405–415. [PubMed] [Google Scholar]
  13. O'Driscoll S. W., Morrey B. F., Korinek S., An K. N. Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop Relat Res. 1992 Jul;(280):186–197. [PubMed] [Google Scholar]
  14. Protzman R. R. Dislocation of the elbow joint. J Bone Joint Surg Am. 1978 Jun;60(4):539–541. [PubMed] [Google Scholar]
  15. Royle S. G. Posterior dislocation of the elbow. Clin Orthop Relat Res. 1991 Aug;(269):201–204. [PubMed] [Google Scholar]
  16. Schwab G. H., Bennett J. B., Woods G. W., Tullos H. S. Biomechanics of elbow instability: the role of the medial collateral ligament. Clin Orthop Relat Res. 1980 Jan-Feb;(146):42–52. [PubMed] [Google Scholar]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association

RESOURCES