Elbow condition
The elbow is the second most commonly dislocated major joint in adults, and a fall onto an outstretched hand is the usual cause of both dislocations and the fractures that go with them. What sets this joint apart is not how it breaks but how it recovers: the elbow stiffens faster and more stubbornly than almost any other joint in the body. That single fact shapes the whole of treatment. A bone that has healed perfectly inside an elbow that will no longer bend or straighten is not a good outcome — which is why getting it moving early, safely, matters as much as fixing the bone.
Tap any that apply — this is guidance, not a diagnosis, but some of these need care straight away.
An injured elbow needs assessing, and some features need it immediately. Visible deformity, numbness or a pale, cold hand mean urgent care now — the nerves and the artery run close to this joint. Otherwise, support the arm and get it X-rayed rather than waiting: fractures here are easily missed, a dislocation should never be manipulated before imaging, and the sooner safe movement begins, the less stiffness you are left with.
If the elbow is sore and stiff without a clear injury, this is more likely a joint or tendon problem than a fracture. Wear, tendon irritation and nerve compression around the elbow all cause pain without trauma, and are assessed differently. More: elbow arthritis
The elbow is a tightly fitting hinge, so the details of the injury decide the treatment closely:
Support the arm, keep it still and get it X-rayed before anyone attempts to put it back. That last point matters more here than most people realise: if a fracture sits alongside the dislocation, manipulating the joint blindly can displace the fragments and turn a manageable injury into a complicated one. Do not let a bystander pull on the arm, and do not try it yourself. Seek care immediately rather than waiting if the elbow looks deformed, if the hand is numb, pale or cold, or if swelling is severe — the nerves and the main artery to the forearm pass close to this joint. Once treatment starts, the priority shifts almost entirely to movement. Ask when you can begin moving it, and then do so diligently, because the elbow stiffens faster than almost any joint and the range you lose early is hard to recover. Keep the shoulder, wrist and fingers moving from day one regardless. And be wary of the instinct to rest it until it feels completely comfortable — that is precisely how people end up with a healed bone and an elbow that no longer straightens.
The right step depends on the stage — tap the one that fits:
Support the arm and get it imaged before anything is manipulated. Deformity, a numb or cold hand, or severe swelling mean urgent care now. Assessment establishes whether the joint has dislocated, whether anything is broken alongside it, and whether the elbow is stable once reduced — which is what decides between early movement and surgery.
Now the work is movement, and the clock is running. Ask exactly when and how much you can move, then follow it diligently — in this joint, early guided movement is the treatment rather than an optional extra. Keep the shoulder, wrist and fingers mobile throughout, and attend the follow-up imaging that confirms the joint has stayed in position.
A stiff elbow after injury is common and worth addressing rather than accepting. Structured hand and elbow therapy recovers useful range for many people, particularly in the first months. Where stiffness has become fixed, releasing the tight capsule and removing scar or bone that blocks movement is an option. Do not assume this is simply how it will be.
Treatment balances two aims at once: restore the anatomy, and protect the movement.
Tap each card to reveal the truth:
The elbow is more prone to losing movement than almost any other joint, and it is worth understanding why. It is a tightly constrained hinge with a thin, closely applied capsule, and it responds to injury and bleeding by laying down scar tissue inside that capsule with unusual enthusiasm. Held still for even a few weeks, it stiffens quickly, and the movement lost is stubborn to win back. That is why the guiding principle after an elbow injury is to get it moving as early as is safe — sometimes within days — and why a bone that has healed perfectly in a stiff elbow counts as a poor result.
It is the distinction that shapes everything. A simple dislocation means the elbow has come out of joint without breaking any bone. Once it is properly put back, the joint is usually stable, and with early guided movement most people do well. A complex dislocation means the elbow has dislocated and fractured at the same time — commonly involving the radial head and the coronoid, together with the ligaments. That combination leaves the joint unstable, generally requires surgery to rebuild it, and carries a much higher risk of stiffness and later arthritis.
Not without imaging first, other than in exceptional circumstances. A dislocated elbow needs an X-ray before reduction, because if there is a fracture alongside the dislocation, manipulating it blindly can displace the broken fragments and make matters considerably worse. Reduction is done with proper pain relief and technique, followed by further imaging to confirm the joint is truly back in position and to look for fractures that were hidden while it was dislocated. Attempting it yourself, or having a bystander pull on the arm, risks converting a manageable injury into a complicated one.
The radial head — the top of the smaller forearm bone — is the commonest elbow fracture in adults, often from a fall onto an outstretched hand, and it is frequently subtle on an early X-ray. Many radial head fractures are undisplaced and do well without surgery, protected briefly and then moved early. Fractures of the olecranon, the point of the elbow, more often need fixing, because the triceps pulls the fragment away and it will not heal in that position. Fractures involving the joint surface of the upper arm bone usually need fixing too, to restore a smooth surface.
It is a common and quite different injury, sometimes called nursemaid’s elbow, in which a young child’s forearm bone slips partly out from under the ligament that holds it — typically after being lifted or swung by the hand, or after a sudden pull. The child suddenly refuses to use the arm and holds it slightly bent and turned in, often without much swelling or obvious deformity. It is not a true dislocation and is usually corrected by a quick, simple manoeuvre, after which the child generally starts using the arm again within minutes. It is worth having it assessed rather than manipulated at home.
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