Stabilisation of unstable elbows

The cost of surgery for an unstable elbow will depend on various factors, including the type of surgery you have and the reasons you are having it.

If you are paying for your own treatment, you'll be given a fixed-price package for your treatment, which includes the surgery as well as any aftercare appointments and physiotherapy you need during your recovery. This price does not include the cost of your initial consultation or any scans or tests you have at that time. These will be charged separately.

We offer flexible payment options for people paying for their own treatment. This allows you to spread the cost of treatment over a period of up to five years, with interest-free options available.

If you have private health insurance, elbow instability treatment will usually be covered by your policy, and we work with all major providers. Call your insurer directly to find out.

An unstable elbow usually happens as a result of an elbow dislocation.

A joint is where two or more bones meet to allow movement. The bones are joined and held into place by tendons ( that attach muscles to bone) and ligaments (that connect bones to joints).

Elbow dislocation occurs when the bones of your lower arm (radius and ulna) move out of place with the bone of your upper arm (humerus).

Types of elbow dislocation

• Simple dislocation - where there is no damage to the bone
• Complex dislocation - where there is damage to the bones and ligaments
• Partial dislocation (subluxation) - where there is a slight misalignment of the bones
• Complete dislocation - where the bones are completely separated
• Severe dislocation - where the nerves and blood vessels are affected

Simple elbow dislocations can usually be treated with a procedure called a closed reduction, where the joint is manipulated back into position under anaesthetic.

Complex or severe dislocations require surgery to put the joint back into the correct position, repair damaged bones or ligaments, and stabilise the joint.

What causes elbow dislocation?

Causes of elbow dislocation include:

• Injury to the elbow such as falling on an outstretched hand, contact sports, or a car accident
• Chronic overuse of the joint for example during sports that involve overarm throwing
• Conditions like osteoarthritis that affect your joints

Recurrent or chronic elbow instability is when the joint repeatedly slips out of place. This may be due to an old elbow injury, although in rare cases there is no clear reason.

Symptoms of unstable elbow vary according to how badly the joint is damaged. A complex or severe dislocation will be extremely painful, with a deformed appearance and possible loss of feeling in the hand and fingers. A simple or partial dislocation may appear normal and have less pain and swelling.

Symptoms of unstable elbow may include:

• Pain
• Swelling
• Bruising
• Inability to bend your arm
• Locking, catching or clicking of the elbow joint
• Loss of feeling in your hand and fingers
• Inability to feel a pulse in your wrist

If you're experiencing any or all of the above symptoms, it might be that your elbow is unstable. Book an appointment with one of our experienced consultants, who will be able to diagnose your elbow problems and recommend the best course of treatment.

At your first consultation, your surgeon will ask you how and when the injury occurred, and what symptoms you have. They will examine your arm and elbow joint for signs of dislocation such as swelling, tenderness, reduced movement, and deformity. They will also check there is no damage to your nerves and blood supply by checking sensation and movement in your fingers and wrist and checking your pulse.

How is a diagnosis made?

Elbow instability is normally diagnosed using a combination of physical examination and X-ray. An X-ray will show if there is any joint dislocation or bone fractures (breaks). It will not show damage to soft tissue such as ligaments.

Your surgeon will decide which treatment is best for you depending on the type of dislocation you have, and whether or not there is damage to the bones or ligaments.

Will I need tests or scans?

Normally a physical examination and an X-ray are enough to diagnose elbow dislocation. If there is possible damage to your arteries or soft tissues, your surgeon may order further tests including:

• Arteriogram (X-ray of your artery) to check for damage to your arteries
• Computerised tomography (CT) scan to look at any bone damage in closer detail
• Magnetic resonance imaging (MRI) or ultrasound scan to check for damage to soft tissues like muscles, tendons, and ligaments

Why is this first consultation so important?

The first consultation is important because it allows your surgeon to examine you, perform any necessary tests, make a diagnosis, and recommend a suitable treatment. It's where we get to know you and what you are hoping to get out of treatment. We create a bespoke treatment plan for every patient, so it's very important for us to have this one-on-one time with you.

If surgery is required, your consultant will talk you through the procedure including before and aftercare. They will also put your mind at rest by answering any questions you may have.

Being physically and mentally prepared for surgery can help you feel less anxious, have a better idea of what to expect, and speed up your recovery.

Before your surgery, your consultant will ask you about any medical conditions or allergies you have, and any medications you are taking. They will perform a complete physical check-up to make sure you don't have any underlying medical problems.

Be sure to ask your surgeon any questions you have about the surgery and recovery. They want you to feel as comfortable and informed as possible.

Before your surgery, your consultant may tell you to stop taking certain medications such as blood thinners and non-steroidal anti-inflammatory drugs (NSAIDs). Check with your surgeon about continuing your other medications if you are not sure.

Your consultant or physiotherapist may give you some exercises to do to strengthen your muscles before surgery. Only do the exercises that have been recommended and don't attempt any other exercises before your surgery.

You won't be able to eat or drink anything from midnight on the day of your surgery.

What lifestyle changes can I make before surgery?

Being as healthy as possible before your surgery will help you to recover faster. Some lifestyle changes you can make before having your surgery include:

• Stopping smoking
• Not drinking more than the recommended limit of alcohol per week (no more than 14 units spread over at least 3 days)
• Losing weight if needed
• Eating a balanced diet with plenty of fruits, vegetables, lean proteins, and whole grains
• Having a positive mental attitude

Do I need to prepare my home for after the surgery?

After your surgery, you will not be able to complete daily activities like cooking and housework for around three weeks. Try to arrange for someone to care for you or check on you during this time. Before you have your surgery, some things you can do to prepare and make your recovery easier include:

• Prepare single-portion meals that can be easily heated up
• Have clean, comfortable clothing on hand
• Keep things you use often in easy reach like the TV remote control, books, and medications
• Remove items you could trip over like rugs and electrical cords

During surgery to stabilise an unstable elbow, the elbow joint is realigned into the correct position, and torn ligaments are reattached to stabilise the joint. If your ligaments are too badly damaged, a tissue graft may be used to provide joint stabilisation.

Depending on the type of surgery you are having, elbow stabilisation surgery normally takes between one and two hours. The procedure is often performed as an arthroscopy (keyhole surgery) however this won't be appropriate in all cases.

Elbow stabilisation surgery is performed under general anaesthetic, which means you will be asleep during the procedure.

Are there different types of stabilisation of unstable elbow?

There are three different stabilisation procedures to correct an unstable elbow. Your surgeon will decide which one you need depending on the type of injury you have.

Ligament repair: If your injury is new and the tissues are healthy, your surgeon may be able to repair the damaged ligaments with sutures (stitches).

Ligament reconstruction: In most cases, it is not possible to repair the damaged ligaments. Your surgeon will replace the ligament with a tissue graft. This is normally made with tissue from elsewhere in your body, but occasionally an artificial ligament may be used.

Fracture fixation: If your unstable elbow involves bone fractures (breaks), these need to be repaired and fixed into place. Bone fragments are put back into their correct position and fixed in place with screws and sometimes a metal plate.

Recovery from elbow stabilisation surgery is different for everyone and depends on factors such as your general health, the type of surgery you have, and any complications that arise. Talk to your consultant about a likely recovery timeline before your surgery.

After your surgery, you will have a course of physiotherapy treatment for approximately six weeks. You will be able to start normal activities after about three weeks but should not take part in sporting activities for around three months.

How many nights will I spend in hospital?

Depending on the type of surgery you have, you will normally go home the same day. Talk to your surgeon about whether you will need to stay in hospital.

Will I be able to drive home?

No. You will need someone to drive you home after your surgery. If you would rather get a taxi, we can help you arrange one.

How soon can I go back to work?

How soon you can return to work depends on your recovery and the type of job you do. Talk to your surgeon about when you can expect to go back to work after surgery. Bear in mind that after surgery your elbow will be in plaster for two weeks, followed by a hinged brace for a further four weeks, meaning you will have limited use of your arm.

How soon can I drive?

You will not be able to drive while your plaster or brace are in place as this is dangerous and will invalidate your insurance. After your brace is removed, your elbow may be quite stiff, and it may still be unsafe for you to drive.

After your surgery, you will have regular appointments with your consultant surgeon to check your progress. They will tell you when it is safe for you to drive.

When will I be back to normal?

Depending on the type of surgery you have, it can take from a few weeks to several months to be completely back to normal following elbow surgery. Your surgeon will be able to give you a more tailored timeline for recovery after surgery, based on your personal circumstances.

Surgery always involves a certain amount of risk, though most of these can be overcome with proper planning, and good pre and post-op care.

You can minimise the risks by making sure you are as healthy as possible before your surgery, and by following your surgeon's instructions carefully before and after your procedure.

Keeping a positive mental attitude and having realistic expectations can also go a long way towards helping your recovery.

Your surgeon and anaesthetist will check that it is safe for you to have surgery before your procedure and explain any risks to you. Talk to your surgeon about any questions or concerns you have about your surgery.

General risks of surgery include:

• Shock
• Blood loss
• Infection
• Blood clots
• Chest problems
• Problems passing urine (urinary retention)
• Allergic reaction to anaesthesia

Possible complications specific to elbow stabilisation surgery include:

• Stiffness and reduced mobility - this normally resolves with physiotherapy
• Arthritis
• Rarely, damage to the artery and nerve that run down the arm

We answer some of the most commonly asked questions about elbow dislocation and unstable elbows.

Can a dislocated elbow heal itself?

Sometimes a dislocated elbow can go back into the correct position on its own, but it may remain unstable and may dislocate again or lead to other problems.

Never ignore a dislocated elbow in the hope that it will heal itself. Even if you think your dislocated elbow has gone back into the right position, it's a good idea to be checked by a doctor to make sure. Delaying treatment for a dislocated elbow could slow your recovery and lead to complications.

How long before I can straighten my elbow after dislocation?

After stabilisation surgery, your physiotherapist will give you some exercises to do to prevent stiffness and slowly increase your range of movement. Never force your arm to straighten or do any exercises not recommended by your physiotherapist. Most people regain a functional range of movement after around six to eight weeks.

How do I know if my elbow is dislocated?

If your elbow is dislocated, you will normally experience extreme pain at the time of the injury which may be accompanied by a click or pop. Your elbow may be at an odd angle, and you will be unable to bend your arm. You may also have swelling, bruising, numbness, and be unable to move your wrist, hand, and fingers. If you experience these symptoms, go straight to your nearest hospital where a doctor will confirm the diagnosis with a physical examination and X-ray.

Can you fix a dislocated elbow yourself?

No. A dislocated elbow is a serious injury that needs to be treated by a doctor. if you have injured your elbow, see a doctor as soon as possible to get an early diagnosis and treatment. Delaying treatment could result in severe complications.

Can you dislocate your elbow by falling?

Yes. One of the most common causes of a dislocated elbow is falling onto an outstretched hand.

Can you dislocate your elbow while sleeping?

As it normally takes quite a lot of force to dislocate your elbow, it is unlikely to happen while you are sleeping. Sometimes a poor sleeping position can trap the nerves that run along your elbow causing problems like cubital tunnel syndrome and radial tunnel syndrome. If you experience numbness, tingling, or a 'dead arm' at night, talk to your doctor or physiotherapist about improving your sleeping position.

Can you partially dislocate your elbow?

Yes, a partial dislocation or subluxation is when the bones that make up the elbow joint have moved slightly out of position. This may be harder to detect as the joint may appear normal and there may be minimal pain. Untreated partial dislocations where the ligaments haven't healed can recur over time, so if you have banged or injured your elbow, have it checked by a doctor to be on the safe side.

Do I need physio after a dislocated elbow?

Yes. Physiotherapy is vital for a successful recovery after elbow dislocation. The aim of physiotherapy is to build strength and restore range of movement through exercises and treatments such as electrotherapy, ice, or heat treatment. Physiotherapy after elbow dislocation speeds and optimises recovery and helps prevent long-term complications and recurrences.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. At Circle Health Group you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant best suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about stabilisation of unstable elbow, book your appointment today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in October 2022. Next review due October 2025.

Elbow Instability: Anatomy, Biomechanics, Diagnostic Manoeuvres, and Testing, Pubmed
Elbow dislocations, Orthoinfo 
Assessment and decision making in the unstable elbow: management of simple dislocations, Pubmed
Elbow stabilisation, OrthTeamCentre
Recurrent and Chronic Elbow Instability, Orthoinfo