What is Elbow Instability?
Elbow instability is a condition in which the elbow joint occasionally slides out of alignment or feels like it is going to slide out of alignment due to an unstable state of the joint.
The elbow joint is made up of three bones: the humerus (upper arm bone), and the radius and ulna (the forearm bones). It consists of a hinge joint that permits flexion and extension of the arm, and a ball-and-socket joint that enables rotation of the wrist. There are three bony junctions in the elbow: the proximal radioulnar joint between the radius and ulna, the ulnohumeral joint between the ulna and humerus, and the radiohumeral joint between the humerus and the radius. The bones are held in position by a number of ligaments.
Causes of Elbow Instability
Elbow instability usually occurs as the result of an elbow injury from a fall, or other trauma with or without elbow joint dislocation. The ligaments and other soft tissues can become damaged as a result of the injury and occasionally don’t heal properly which can then lead to ongoing instability. Elbow ligament injuries are injuries to the tough elastic tissues that connect the bones of the elbow joint to each other. These ligaments stabilize the elbow while allowing an appropriate joint range of motion to occur. An acute or chronic injury to the elbow ligament can result in joint laxity and loss of elbow function.
Trauma-related: These causes may generally result in lateral collateral ligament injuries, including fracture or dislocation due to the forced twisting or inward movement of the arm into varus position accidentally or due to a fall.
Injuries due to overuse: These causes may generally result in medial collateral ligament injuries which are due to the outward angulation of the joint.
Instability can also be associated with:
- Previous elbow surgery
- Elbow deformity
Symptoms of Elbow Instability
The various signs and symptoms of elbow instability include:
- Pain with arm movements such as bending or throwing
- Locking or catching of the elbow
- An unstable sensation
- A clicking sound
- Occasionally recurrent episodes of dislocation
Diagnosis of Elbow Instability
Your doctor will diagnose elbow instability based on your medical history and a physical examination. Once the preliminary diagnosis is complete, your doctor may use imaging techniques such as X-ray, MRI, or MRI arthrography to obtain a detailed view of the elbow and look for other injuries.
Treatment of Elbow Instability
Different treatment methods are used based on the severity of the condition.
Most cases of elbow instability can be managed by nonsurgical treatment including rest, activity modification, and physical therapy. A sling or brace may be used to keep the elbow immobile for a specific duration to facilitate healing. Simple range of motion exercises may be recommended to improve movement and strengthening of the muscles will aid in stability.
In some cases, surgical treatment may be necessary to restore elbow stability. This may involve repair or reconstruction of damaged ligaments.. A tendon graft is usually used to reconstruct a new ligament for the elbow and is attached by drill holes in the bone. A defined recovery period and physical therapy are required following surgery, with full recovery taking at least 6 months.