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Trauma to elbow and associated dislocation in sport

Doctor's Corner with DR JOSEPH KABUNGO
THOUGH most of the injuries in sport affect the lower limb, it is the injuries to the upper limb, which can be worrisome.

Dislocations of the shoulder joint are common and can lead to prolonged absence from sport.
In the same line elbow dislocations cannot be ignored.
Elbow problems in football can prevent further participation in the game.
One such common elbow problem is that of trauma resulting in dislocation or fracture.
It can also take the form of prolonged and recurrent elbow pain attributed to repeated landing on the elbow especially in goalkeepers and at times it is the repeated use of the affected limb in sports such as tennis, badminton, rugby and wrestling which can result in injury to the elbow.
In football, elbow dislocations can occur when there is a bad fall.
All this will result in forces transmitted to the elbow and shoulder joint which might result in damage to the structures holding the elbow joint together resulting in dislocation.
A dislocated elbow will be a scary sight to the people around because there will be an obvious distortion in the normal appearance of the elbow joint.
The affected part will look abnormal because the elbow will lose its normal contour or appearance and the player will experience severe excruciating pain.
This is a time when a panic button will be pressed for immediate evacuation to a nearest medical facility.
It is important to appreciate the basic anatomy of the elbow joint, which is formed by three bones, which are the ulna and radius from below and the humerus from above.
Whenever a dislocation occurs around the elbow joint, the ulna with its protruding part, which is called, the Olecranon process is displaced from the cavity like part on the humerus, known as the Olecranon fossa.
The relationship, which exists between the radius, ulna and humerus, is also lost.
The displacement, which happens most of the time, is the movement of the olecranon process backwards and behind the humerus.
It must also be appreciated that the dislocation can happen as an isolated injury in about 70 percent of cases and then it can also have a fracture accompanying it in the remainder of cases. When the dislocation does not include a fracture then the dislocation is referred to as a simple dislocation and if accompanied by a fracture, the dislocation is termed complicated.
This type of simple dislocation is referred to as a Posterior Elbow Dislocation.
It really does not worry me on how the dislocations are classified whether simple or complicated but my main concern is how the injury is handled.
The worst scenario is when there is a fracture complicating the dislocation and there is damage to the nerves that is made worse by the initial wrong handling of the dislocation.
It is the more reason why a qualified medical person is needed on the sidelines so that problems of this nature are minimised.
It is important that a simple dislocation is treated quickly by pushing back the displaced part to its original position.
This is on the assumption that there is no complication associated with that.
When a dislocated part is pushed back to its original position it we refer to this as reducing the dislocation.
After a successful reduction of a dislocated joint there will be obvious swelling, which will result because of the associated damaged surrounding structures.
When a dislocation happens it will cause injury to other structures such as the ligaments, joint covering called capsule and other soft tissues.
This is the reason why pain, swelling will be prominent after a simple dislocation.
A well-attended to simple dislocation in football will result in a good functionality of the joint.
A complicated elbow dislocation can be career threatening especially when the affected player is a goalkeeper. Goalkeepers always need well-functioning parts of the upper part especially the shoulders, elbows, wrists and fingers.
A complicated dislocation will need specialist treatment.
A lot of young people with poorly managed or treated elbow joint dislocations have ended up having a frozen joint or a joint which has lost its normal range of movement.
The other complications, which might occur, can involve the blood supply and nerve supply to the affected limb.
It is important to remember that any form of excessive trauma or force to the elbow can result into a dislocation, which can either be simple or complicated.
Simple dislocations are easy to treat whilst complicated dislocations are delicate and will most often require surgical repair.
For questions and comments write to Dr Kabungo Joseph
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