Assessment and Management of Complex Elbow Dislocations

Elbow dislocation is one of the most frequent injuries following shoulder dislocation. It is classified into simple and complex dislocation. Simple elbow dislocation involves capsuloligamentous stabilizers disruption without a fracture. Complex elbow dislocations involve an elbow dislocation alongside fractures of one or more critical bony stabilizers. Complex dislocation can lead to various long-term complications, particularly following suboptimal management. Diagnosis of complex elbow dislocation includes history taking, physical examination, and imaging. Classification and assessment of complex elbow dislocation can be confusing due to the separate classification systems. It can be treated by nonoperative treatment and operative treatment based on the severity and direction of dislocation. However, the choice of appropriate treatment plan for complex elbow dislocation and its effectiveness are still debatable. The aim of this review is to explore recent and current advancements in the assessment and management of complex elbow dislocation. The most common complex elbow dislocation is the posterolateral complex dislocation. Posteromedial dislocation and anterior dislocation are other mechanisms of elbow complex dislocation. This type of dislocation can be classified by different classification systems, including Regan-Morrey classification, O’Driscoll classification, and Mason-Johnston classification. The aim of treatment of complex elbow dislocation mainly includes restoring anatomical alignment of the joint, ensuring stability, and enabling early motion. Surgical treatment is considered the cornerstone of most unstable dislocations. A structured, individualized treatment approach, including timely surgical intervention, anatomical reconstruction, and early mobilization, is key to optimizing outcomes and minimizing long-term morbidity.