72.3 Elevating and aspirating the elbow

An injured elbow rapidly swells, and makes reduction of a fracture difficult. As with the knee, aspirating the blood from a tensely distended elbow joint relieves pain, and allows the patient to move his elbow much earlier. Some surgeons consider this an an important part of the active movements treatment of comminuted supracondylar fractures in adults (72.11), and especially of fractures of the head of the radius (72.15). Other surgeons never aspirate an injured elbow.

If an elbow is dislocated reduce it immediately. If it is fractured and too swollen to reduce immediately, put the patient’s arm up in forearm traction as in Fig. 72-11.

ASPIRATING THE ELBOW Clean the patient’s skin carefully, paint it with iodine, and taking the most careful aseptic precautions, aspirate at the summit of the swelling between the 3 bony points on the outer side of the elbow, as in Fig. 72-4.

CAUTION! Don’t put anything into the joint except the tip of a sterile aspirating needle.

Figure 72.5: AN X–RAY OF A DISLOCATED ELBOW The sooner you reduce a dislocated elbow the easier this wilt be, and the fewer the complications.