Additional Information
Elbow dislocations
The 2nd most common large joint dislocation
Over 90% are posterior or posterolateral
Most commonly caused by a fall on an outstretched hand
Single provider reduction technique:
Leverage technique
The leverage technique, first described by Hankin in 1984, offers an alternate single-person technique for the reduction.
With this technique, the clinician interlocks their fingers with the patient’s fingers in a clasping grip
If the patient has a longer forearm length than the clinician, grasp the patient’s wrist instead of their fingers for this technique.
The clinician then places their elbow against the distal portion of the patient’s biceps muscle until tension is felt on the patient’s flexed arm.
The clinician then slowly draws the patient’s arm into hyperflexion, using their elbow as a fulcrum at the patient’s elbow joint.
The clinician can use their other hand to guide the patient’s olecranon over the distal humerus.
A modification has also been described, wherein the clinician uses their contralateral hand to apply a distracting force on the patient’s forearm.
Hankin reported that all 77 cases were successfully reduced without complications using this technique, and another study reported a 100% success rate (10 dislocations).
Key advantages
- No assistant required — performed by a single operator
- No special equipment needed
- Uses leverage rather than brute force, reducing soft tissue trauma