Elbow dislocation in Vienna
A fall onto the outstretched hand, a jolt — and the forearm jumps out of its joint. The elbow is put back in place in the emergency department; what happens afterwards decides whether it will move freely again and be held securely. I take on this aftercare in my practice in Vienna-Döbling.
In short
In an elbow dislocation, the ulna and radius lose contact with the upper arm bone, almost always as a result of a fall onto the outstretched hand. The arm is locked in a springy, fixed position and cannot be moved; the joint is put back in place under pain relief in the emergency department. After that, the findings decide: in a simple dislocation only the capsule and ligaments are injured, whereas in a complex one bone is broken as well. I usually treat the simple form without an operation — with brief immobilisation and early guided movement to counter the two follow-on problems, stiffening and residual instability.
What is an elbow dislocation?
At the elbow, the upper arm bone, ulna and radius meet, held in position by a taut joint capsule and two collateral ligament complexes. It takes a great deal of force to push the forearm out of this joint — usually a fall onto the outstretched hand while the body keeps turning over it. In most cases the forearm is displaced backwards, and the soft tissues tear from the outside inwards: first the outer ligament complex, then the capsule and finally the inner collateral ligament.
If the injury stops there, it is called a simple dislocation; after reduction (putting the joint back in place) the joint is usually held securely again, and the ligaments heal with the right aftercare. If bone breaks as well — typically the radial head or the coronoid process of the ulna — the dislocation is complex: the joint lacks its bony stop. If the radial head and the coronoid process both break, this is known as the “terrible triad”. After every dislocation I keep an eye on two follow-on problems: stiffening, because the capsule scars quickly, and residual instability, if the ligaments heal with poor tension. Other conditions are covered in the overview elbow specialist in Vienna.
Typical symptoms
- Visible deformity — the elbow looks displaced and the olecranon (the point of the elbow) protrudes
- Springy block — the arm can be neither straightened nor bent
- Swelling and bruising — the joint swells up quickly
- Numbness, tingling or cold fingers — warning signs for nerves or blood vessels; go to the emergency department at once
- Loss of extension after reduction — the arm remains bent, see stiff elbow
- Feeling of instability when propping yourself up — a sign of residual elbow instability
How I make the diagnosis
First, I ask you to describe the accident: how did you fall, and what does the report from the emergency department say? Please bring all images from before and after the reduction. I then check tender points, range of movement and stability under sideways stress, as well as sensation, strength and circulation in the hand.
Ultrasound is available in the practice: for joint effusion, the ligament complexes and tendon attachments, and to see how far the joint opens up. Where needed, I arrange an X-ray, a CT scan if bone is involved, and an MRI for ligaments and cartilage. If the findings remain unclear, elbow arthroscopy shows the capsule, cartilage and ligament attachments under direct vision.
Treatment: conservative first
The reduction belongs in the emergency department: there the joint is put back in place under pain relief and then X-rayed. Never try to push the arm back yourself. My work begins after that. I usually treat a simple dislocation without an operation: brief immobilisation in a splint, then guided movement as early as possible, often in a brace that limits the range of movement.
The reason for the urgency: the injured capsule scars quickly, and the longer the arm stays immobilised, the harder it is to regain extension. I avoid passive stretching in this phase. The exercise programme is provided by physiotherapy and exercise therapy, both available in the same building at the Orthozentrum Döbling. If pain is blocking movement, an ultrasound-guided injection helps, supplemented by magnetic field therapy; if a tendon attachment is irritated, shockwave therapy or PRP therapy may be considered. The aim is to relieve the pain and to regain extension.
For patients who are active in sport, I weigh things up differently: if the outer ligament complex is torn or the elbow does not stay securely in place after reduction, I discuss surgical stabilisation or ligament reconstruction at an early stage — anyone who wants to get back to throwing, taking weight on the arm or contact sport needs a joint that holds securely under load.
When an operation is necessary
Surgery is performed when the joint does not stay securely in place after reduction, when bone is broken as well, or when nerves, blood vessels or the skin are also injured. In a complex dislocation, I first restore the bony stop: the radial head and coronoid process are treated, and in addition I reattach the outer ligament complex that has torn away. The aim is a joint that is stable enough to be moved again early.
Some problems only become apparent over time. If the elbow remains stiff, I release the scar tissue arthroscopically (arthrolysis) and remove loose bodies; if the arm remains unstable, a reconstruction of the affected ligament may be considered. If the ulnar nerve is compressed, I release it in the same procedure. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. Whether an operation makes sense depends on the findings; we decide together as soon as all the images are available.
Frequently asked
Frequently asked questions about elbow dislocation
Go to an emergency department straight away and do not try to push the arm back into place yourself — doing so can cause additional damage to cartilage, ligaments and nerves. Support the arm in the position in which it hurts least, and do not eat or drink anything more in case an anaesthetic is needed. Numb, pale or cold fingers are an emergency.
In a simple dislocation, only the capsule and ligaments are injured; once the joint has been put back in place, it is usually held securely in position again. A dislocation is called complex when bone is broken as well, for instance the radial head or the coronoid process of the ulna. The joint then lacks its bony stop and, as a rule, has to be restored surgically.
No. I usually treat a simple dislocation without an operation: brief immobilisation, then guided movement under the instruction of a physiotherapist, and check-ups to see whether the joint stays centred. Surgery is performed when bone is broken as well, when the elbow does not stay securely in place, or when nerves, blood vessels or the skin are also injured.
Because the injured joint capsule scars quickly. If the arm stays in a splint for a long time, the capsule shrinks and extension returns only slowly and with difficulty. If the joint is stable once it has been put back in place, I therefore start guided movement early within a safe range and widen that range step by step, as far as stability allows.
A loss of extension is the typical follow-on problem, and a small residual lack of extension sometimes remains. With early guided movement and physiotherapy, most of the movement can usually be regained. If the arm remains permanently restricted, I can release the scar tissue arthroscopically — this procedure is called arthrolysis and is only considered once the conservative options have been used.
This is possible above all if bone was injured as well or if the ligaments have healed with poor tension. More common than a repeat dislocation is a feeling of instability when you prop yourself up on the arm, a snapping sensation or a brief giving way. You should have such signs assessed: they are often due to an instability of the outer ligament complex.
As soon as possible. The first check-ups show whether the joint stays centred and determine when a wider range of movement can be allowed. Please bring everything you have: your e-card, the report from the emergency department and the X-ray and CT images from before and after the joint was put back in place. You do not need a referral; appointments are by arrangement.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. For an operation, direct settlement with a supplementary private insurance is possible.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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If your elbow is not regaining its movement after a dislocation, or if it feels unstable when you prop yourself up on it, I will be happy to look at the findings. You can reach the practice by telephone Monday to Friday from 9:00 to 16:00 on 01 2080145. The process from the invoice to reimbursement is described on the page about billing in a private practice.
Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.