Elbow dislocation.

Mechanism

Fall onto an outstretched hand

Classification

Simple (no fracture) or complex

Initial treatment

Closed reduction + back slab

Brace

ROM brace for 6 weeks

Functional ROM

12–16 weeks

Return to sport

17+ weeks

What it is.

An elbow dislocation occurs when the bones of the forearm - the radius and ulna - are displaced from their normal alignment with the humerus. The mechanism is almost always a fall onto an outstretched hand. A “simple” dislocation has no associated fracture; a “complex” dislocation involves one or more fractures around the elbow joint.

After reduction (putting the joint back into place), the key challenge is restoring range of motion while maintaining stability. The elbow is particularly prone to stiffness, and early supervised mobilisation is critical.

Diagnosis and initial management.

The diagnosis is confirmed with plain X-rays, which also identify any associated fractures. A CT scan is obtained where fractures are seen or suspected. The neurovascular status of the hand is assessed carefully, as nerve stretch injuries can occur at the time of dislocation.

Reduction is performed under sedation or anaesthesia. The elbow is then placed in a back slab or hinged brace, and X-rays are repeated to confirm a congruent joint. Surgical stabilisation is considered for complex dislocations with unstable fracture patterns, for persistent instability after reduction, or for recurrent dislocations.

Why structured rehabilitation matters.

The elbow is unforgiving of prolonged immobilisation. Stiffness is the most common complication after dislocation, and the risk increases with each additional week of immobilisation beyond the initial protective period. A structured, physiotherapist-led rehabilitation protocol is essential to balance the competing demands of stability and mobility.

Rehabilitation protocol.

A written copy of this protocol is provided to your physiotherapist on the day of injury. The timeline below is a guide - progression is based on clinical milestones, not the calendar alone.

Phase 1 - weeks 0–2 (immediate post-reduction)

• Neurovascular observations as directed.
• Pain control and swelling management.
• Back slab transitioned to a range-of-motion brace, initially locked at 90 degrees.
• Supervised range of motion commenced supine with the humerus vertical - active and passive elbow flexion and extension.
• Forearm rotation exercises at 90 degrees of elbow flexion.
• Supine ROM exercises twice daily.
• Medical review with X-rays (and CT if required).

Phase 2 - weeks 3–4 (early mobilisation)

• Brace unlocked to 30–130 degrees of motion.
• Encourage active ROM within the brace.
• Passive forearm rotation exercises.
• Supine brace-off exercises with 1 kg co-contraction (triceps and brachialis working together).
• Medical review with repeat X-rays.
• If major stiffness is present: Mayo Aircast (turnbuckle orthosis) for 3 hours per day, alternating between flexion and extension settings.

Phase 3 - weeks 5–6 (progressive mobilisation)

• Unlock brace to full range.
• Active and passive ROM exercises out of the brace.
• Eccentric strengthening of the elbow, forearm and wrist.
• Ensure shoulder and scapula range is preserved.
• Medical review.

Phase 4 - weeks 7–16 (strengthening)

• Brace removed.
• Mayo Aircast continued if residual stiffness persists.
• Progressive strengthening as tolerated.
• Review as required.

Phase 5 - week 17 onwards (return to activity)

• Return to normal sport and activities as strength and range of motion allow.

View the recovery roadmap for the full rehabilitation journey, or visit For Physiotherapists for protocol requests.

Frequently asked questions.

References.

1. Josefsson PO, et al. Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. J Bone Joint Surg Am. 1987;69(4):605–608.
2. Anakwe RE, et al. Patient-reported outcomes after simple dislocation of the elbow. J Bone Joint Surg Am. 2011;93(13):1220–1226.