Q: Every single one of our four children have dislocated one of their elbows in the last two years. Fortunately they were the kind that could be popped back in place easily. We can hardly believe this has happened so many times but wonder if there's some genetic defect that can account for it. They were all activity-related (sports mostly). Is this a common hereditary problem or just a fluke?
A: The elbow is the second most commonly dislocated joint in adults (after shoulder dislocation). But children and teens also experience a large number of elbow dislocations from simple to severe. The expression "simple" elbow dislocations means is that surgery was not needed to put the elbow back in place and there were no bone fractures.
Elbow dislocations can be complete or partial. A partial dislocation is referred to as a subluxation. The amount of force needed to cause an elbow dislocation can be enough to cause a bone fracture at the same time. These two injuries (dislocation-fracture) often occur together. Any trauma severe enough to dislocate a joint can also cause soft tissue damage.
So, how often do simple elbow dislocations occur? Based on data collected from 102 hospital-based emergency departments or trauma centers, there are approximately 37,000 cases of simple elbow dislocation in the United States each year.
The majority of those occur from falls in 10 to 19 year olds engaged in sports activities. Football, wrestling, and basketball seem to be the activities males are involved in most often when this type of injury occurs. Younger males sustain elbow dislocations more often than females. In older adults, the tables are turned and women are more likely to experience elbow dislocations.
Young females with elbow dislocations are more likely to be participating in gymnastics or skating at the time of the injury. Elbow dislocations were also reported in both males and females as a result of biking accidents, skiing or snowboarding, hockey, lacrosse, track, volleyball, and trampoline.
There may be a genetic link in your family if everyone has a type of collagen fiber that results in joint laxity (looseness) but it is more likely that the sports activity is the real risk factor for your family. This is certainly something you can ask your family physician or the orthopedic surgeon who treated each one.
Anyone who has had one elbow dislocation should take some steps to prevent such injuries. The proper use of protective equipment along with education and training may prevent recurrence. A few visits with a Physical Therapy may help. The goals of therapy are to restore normal motion, joint proprioception (sense of position), and motor control. The program will progress to include strengthening and sport-specific training for athletes.
Reference: Jason W. Stoneback, MD, et al. Incidence of Elbow Dislocations in the United States Population. In The Journal of Bone and Joint Surgery. February 1, 2012. Vol. 94A. No. 3. Pp. 240-245.
Is it a common hereditary problem that all our children dislocated one of their elbows?
