General Guideline Principles for Elbow Dislocations

for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Elbow Dislocations.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Elbow Dislocations

Only the shoulder is dislocated more frequently in terms of clinical occurrence, and dislocation of the elbow typically results from major, high-force trauma. The most frequent mechanism, which causes a posterior dislocation in 98% of cases, is falling onto an outstretched hand.

Common presenting concerns include excruciating pain and a hand- or elbow-related incapacity to function. A fracture and a dislocation together are referred to as a complicated fracture or complex instability.

Vascular and neurological issues frequently accompany fractures. 10% of the time, radial head fractures are found. The terrible triad injury is characterised by a dislocation, radial head, and ulnar coronoid process fracture.

Diagnostic Criteria of Elbow Dislocations

Dislocations are diagnosed using a combination of the usual triggering event (often a fall or trauma) together with deformity and loss of arm use. A persistent dislocation involves deformity and a full inability to utilise the arm.

Special Studies and Diagnostic and Treatment Considerations of Elbow Dislocations X-Rays

Special Studies and Diagnostic and Treatment Considerations of Elbow Dislocations X-Rays are recommended for elbow dislocation, at least two to three views are necessary to rule out fractures. After reduction, further x-rays are advised.

Initial Care of Elbow Dislocations

There are no high-quality studies available for the diagnosis or care of dislocated elbows. To rule out associated injuries, the motor, sensory, and circulatory systems must be examined. The dislocated elbow should be treated medically, says

To ensure that there is no fracture, include an x-ray. A medical expert with knowledge of joint relocation should lower the elbow as soon as feasible if it is still dislocated. An anesthetic injection into the swelling joint area might be beneficial.

It becomes more likely that general anaesthesia will be needed to properly lower the elbow the longer it is dislocated. To confirm that the reduction was successful and that there was no loose body present, post-reduction x-rays and an examination were required.

For ten days, a posterior splint must be used. Exercises for range of motion are advised following immobilization. Exercises to increase range of motion should focus largely on the elbow, but they should also target the shoulder (to avoid frozen shoulder) and wrist.

General Anesthesia to Facilitate Reduction in Select Patients

General Anesthesia to Facilitate Reduction in Select Patients are recommended to aid in reduction in a few chosen patients.

Indications − Failure to achieve reduction, which typically involves intraarticular injection of anaesthetic.

Rationale for Recommendation – Most patients can achieve adequate muscle relaxation for reduction without needing general anesthesia. General anesthesia is utilized in situations where reduction is not achieved and intraarticular injection with anesthetics is insufficient to achieve reduction and is thus advised when other measures fail.

Monitoring Progress of Elbow Dislocations

Seven to ten days after reduction, patients should have another evaluation. At that point, range-of-motion activities should be advanced. Additional testing is advised if there is a failure to progress, especially to rule out fracture.

Activity Modification and Exercise of Elbow Dislocations

After reduction, the majority of patients with a dislocated elbow receive treatment with a posterior splint. In order to avoid extensive rehabilitation to restore normal range of motion when the splint is removed, they are typically told to undertake a modest range of motion exercises a few times each day. Interventions are also made available to address changes in ADL and IADL performance.

Medications of Elbow Dislocations

For the majority of individuals, older NSAIDs like ibuprofen, naproxen, or endorsed as first-choice treatments. Acetaminophen or an equivalent.For people who are not responding well to NSAIDs, paracetamol) may be a viable substitute candidates for NSAIDs, despite the majority of research indicating that acetaminophen is somewhat less efficient.

There is proof that NSAIDs are just as useful for treating pain as opioids, such as tramadol, for pain are less dangerous.

  1. Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

    NSAIDs for Treatment of Elbow Dislocation or Post-Operative Elbow Reduction

    NSAIDs for Treatment of Elbow Dislocation or Post-Operative Elbow Reduction are recommended for post-operative elbow reduction or the treatment of elbow dislocation.

    Indications – NSAIDs are advised as a kind of treatment for elbow dislocation or post-operative elbow reduction. First, try over-the-counter (OTC) medications to see whether they work.

    Frequency/Duration – For many patients, as required, use may be suitable.

    Indications for Discontinuation – elbow pain relief, absence of effectiveness, or the emergence of unfavorable effects that are necessary discontinuation.


  2. NSAIDs for Patients at High Risk of Gastrointestinal Bleeding

    NSAIDs for Patients at High Risk of Gastrointestinal Bleeding are recommended for misoprostol, sucralfate, histamine Type 2 receptor blockers, and proton pump inhibitors are commonly used together by individuals who are at high risk of gastrointestinal bleeding.

    Indications – Cytoprotective drugs should be taken into consideration for patients with a high-risk factor profile who also have indications for NSAIDs, especially if a prolonged course of treatment is planned. Patients who have a history of gastrointestinal bleeding in the past, the elderly, diabetics, and smokers are at risk.

    Frequency/Dose/Duration – H2 blockers, misoprostol, sucralfate, and proton pump inhibitors are advised. dosage recommendations from the manufacturer. It is generally accepted that there are no significant differences in effectiveness for preventing gastrointestinal bleeding

    Indications for Discontinuation – intolerance, the emergence of negative effects, or the stopping of NSAID.


  3. NSAIDS for Patients at Risk for Cardiovascular Adverse Effects

    NSAIDS for Patients at Risk for Cardiovascular Adverse Effects are recommended The first-line treatment options of acetaminophen or aspirin seem to be the safest in terms of cardiovascular side effects. If necessary, non-selective NSAIDs are preferred to COX-2-specific medications.

    To reduce the chance that an NSAID will negate the protective effects of low-dose aspirin in patients receiving it for primary or secondary cardiovascular disease prevention, the NSAID should be taken at least 30 minutes after or eight hours before the daily aspirin.


  4. Acetaminophen for Treatment of Elbow Pain

    Acetaminophen for Treatment of Elbow Pain is recommended for the treatment of elbow discomfort, especially in patients who have NSAID contraindications.

    Indications – All individuals, regardless of how severe or mild their elbow pain is

    chronic and following surgery.

    Dose/Frequency – As per the manufacturer’s recommendations; can be used as required. Over four gm/day, there is evidence of liver toxicity.

    Indications for Discontinuation – pain, side effects, or intolerance are gone.


  5. Opioids

    opioids are recommended for the treatment of a few people who have elbow dislocation pain.

    Indications − Choose patients who have severe pain from elbow dislocation that has not been adequately controlled by conventional treatments, such as acetaminophen and NSAIDs, or who have NSAID contraindications. Opioids should be used with extreme caution, and just the bare minimal number of doses should be provided because elbow dislocation treatments are typically relatively brief.

    Frequency/Dose − dosage based on need. Most of the few people who do need opioids only need medication for a few days to a week at most, and then typically don’t have enough pain to continue receiving opioids.

    Indications for Discontinuation − sufficient pain relief to avoid.

    Need opioids, non-prescription opioid consumption directions, negative effects.

    Rationale for Recommendation – Opioids are not typically needed by patients. Opioids may be necessary for some individuals, especially those who have more severe dislocations.


  6. Anaesthetic Intra Articular Injections for Pre- or Post-Reduction Pain

    Anaesthetic Intra Articular Injections for Pre- or Post-Reduction Pain are recommended either pre-reduction or post-reduction for pain


    Indications − Pre-reduction for pain management and to aid reduction, or post-reduction for pain management.

    Short- or intermediate-acting injectable anesthetics: frequency/dose are suggested. Typically, only one injection is required. approximately 5 to 10mL. In some instances, a second may be reasonable.

    Frequency/Dose − Injections of intra articular anesthesia are typically not necessary for patients. Some people need these injections to help them manage their pain well enough to reduce their need for general anaesthesia. Some people need these injections for pain relief following reduction.

    Pre-reduction injections typically use more potent, short-acting anesthetics, but post-reduction injections typically use stronger, longer-acting anesthetics. These injections are advised to help with pain management and/or decrease.

Physical Methods/Devices of Elbow Dislocations

Posterior Elbow Splint and Sling for Dislocated Elbow

Posterior Elbow Splint and Sling for Dislocated Elbow are recommended for the treatment of elbow dislocations.

Indications – elbows that dislocated after reduction.

Duration- Typically, posterior splints are worn for 10 to 17 days. Exercises for range of motion are advised following immobilisation.

Surgery of Elbow Dislocations

If ligaments are so slack that they become unstable or cause recurring dislocations, surgery may be necessary to fix them.

Surgery for Elbow Joints That Recurrently Dislocate or Are Unstable After Dislocation

Surgery for Elbow Joints That Recurrently Dislocate or Are Unstable After Dislocation are recommended to fix elbow joints that often dislocate or become unstable following a dislocation (s).

Indications − Recurrent elbow dislocations and/or unstable elbows after dislocation(s)

Rationale for Recommendation – Most people do not require surgical correction following a dislocated elbow. Nevertheless, some people have unstable joints because of ligaments or Capsular laxity and injury.

Others experience dislocations repeatedly. Operative repair is successful in some cases to address or improve these problems, and is advised for chosen patients.

What our office can do if you have Elbow Dislocation

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.

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Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
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23:31 19 May 22
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Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
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19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
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Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18


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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

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