Elbow Fracture

Have you sustained an elbow fracture? A broken elbow is not a minor injury. What kind of fractures can occur in the elbow? Is surgery always necessary? What kind of recovery can you expect? Getting the answers to these questions can help you obtain the best outcome and ensure return of your elbow function.



Elbow Anatomy

The elbow is comprised of three main bones: the humerus, radius, and ulna. The humerus is the bone that extends up to the shoulder and together the radius and ulna make up the forearm. A fracture to any one of these bones that comprise the elbow can be classified as an elbow fracture.

Elbow Anatomy

Causes of Elbow Fractures

The most common cause of a broken elbow is trauma. A fall on an outstretched arm, an auto accident, or even direct contact can result in an elbow fracture. Broken elbows are the most common type of fractures in children. The most common ways children fracture an elbow is falls from jungle gyms, skateboards, gymnastics, football, and other contact sports. It is not uncommon for fractures to also be associated with elbow dislocations.

Signs and Symptoms

How do you know if you have a broken elbow? The most often symptom is immediate pain after the trauma has occurred. Often swelling will occur and the ability to move the elbow may be limited. Sometimes it is obvious that a fracture has occurred as the elbow will look disfigured. However, fractures can be present even when you are experiencing minimal pain, have little swelling, and no obvious deformity. Of course a diagnosis of a fracture can only be made by x-ray.


Types of Elbow Fractures

There are a variety of types of fractures in the elbow. From a general perspective, a fracture in an elbow can be classified as any other fracture. Non displaced fractures are fractures were a crack in the bone occurs but the bones stay in place. Displaced fractures result when the two ends of the bone that is fractured are no longer in contact. Other classifications of fractures include open vs. closed. An open fracture occurs when the bone protrudes through the skin whereas in a closed fracture the bones do not break the skin.

Because there are three bones that comprise the elbow, a fracture of any part of one of these three bones can be classified as an elbow fracture. One of the most common types of broken elbow is an olecranon fracture. The olecranon is the tip of the elbow and is most commonly fractured from a direct fall and is most often associated with elbow dislocations. Other types of fractures in the elbow include: radial head, radial neck, coronoid, capitulum, medial condyle or epidondyle, and supracondylar fractures.


Elbow Fracture Treatment

The best treatment option will be determined by the type of fracture sustained. If it is a simple, non-displaced fracture, the best course of treatment is immobilization. In some cases a cast will be recommended and in others a brace. The position of your arm for casting will in part be based on the location of the fracture with the goal of ensuring appropriate healing. In addition, depending on the bone that is fractured, the wrist may also need to be immobilized. A second factor in cast positioning is placing the arm in a position that will be functional. Because the elbow can get stiff very quickly with immobilization, sometimes a brace will be used instead of a cast in order to allow for early movement.

If the fracture sustained is displaced, or specifically if the fracture extends into the joint, surgery will most likely be necessary. The type of surgery performed is open reduction, internal fixation or ORIF. This simply means the bones are relocated in place and a pin, plate, or wire is used to fixate or keep the ends of the bones aligned.


elbow fracture


Following surgery a period of immobilization in a cast or brace will be required in order to allow for healing to occur. On average fractures take six to eight weeks to heal, however, a shorter period of immobilization is generally recommended in order to avoid loss of function.


Physical Therapy

An integral part of recovering from a broken elbow is physical therapy. As indicated earlier, an elbow will get stiff very quickly, in as little as 7 to 10 days, with immobilization. Thus, after up to six weeks of immobilization, regaining normal range of motion after can be difficult. The most difficult range to regain is extension or the ability to fully straighten the elbow. Because of this challenge it is important to initiate therapy early and be consistent with the prescribed exercises.

In addition to regaining elbow range of motion, physical therapy will help restore normal strength of the shoulder, elbow, and wrist. Recovery from an elbow fracture can take a number of months. Through physical therapy the goal of returning the elbow to normal function including cutting food, carrying groceries, and throwing a ball can be achieved.


What Can You Do?

What can you do to make sure you have the most optimum recovery from your broken elbow? First, early diagnosis is key. If you are having lingering elbow pain that has not responded to rest, see a doctor for a diagnosis. Getting an accurate diagnosis is the most important starting point for mapping out the path to recovery.

Second, make sure you are clear about what your doctor and physical therapist are recommending you to do, specifically when it comes to immobilization vs. movement. Often a lack of clear understanding results in patients not doing anything which can have negative results. Take the time to ask questions so there is no confusion as to what is expected of you.

Finally, follow your doctors' and physical therapists recommendations. A lack of following through with recommendations is the most common reason for poor outcomes. Therefore, if range of motion exercises are recommend three times a day, do them. If your physical therapist recommends utilizing ice to minimize swelling, use ice. If pain medication has been prescribed so you can tolerate the range of motion exercises, take the pain medication. It may sound like common sense but understanding and actually following the instructions will put you in the best position to regain normal elbow function.

An elbow fracture can be a significant injury depending upon the type, location, and severity of the fracture. Early treatment and physical therapy can help you ensure you’ll be able to regain normal function.


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References

J Orthop Sci. 2013 Jan; 18(1):1-7. Doi: 10.1007/s00776-012-0333-6. Epub 2012 Jan 11. Current concepts of elbow-joint disorders and their treatment. Ingaki K.

Open Orthop J. 2012;6:429-39. Doi: 10.2174/18741874325001206010429. Epub 2012 Oct 2. A survey of practice patterns for rehabilitation post elbow fracture. Macdermid JC, Vincent JI, Kieffer L, Kiefer A, Demaiter J, Macintosh S.

Bratisl Lek Listy. 2011;112(9):501-5. Results of early surgical treatment of intra-articular complex fractures of the humerus in adults. Kilicarslan K, Bektaser B, Ucguder A, Dogan M, Ugurlu M, Yildirim H.

J Orthop Trauma. 2012 Jan;26(1):62-5. Closed reduction and early mobilization in fractures of the humeral capitellum. Puloski S, Kemp K, Sheps D, Hildebrand K, Donaghy J.

Cochrane Database Syst Rev. 2011 Jun 15;(6):CD008130. Early mobilisation for elbow fractures in adults. Harding P, Rasekaba T, Smirneos L, Holland AE.

Instr Course Lect. 2003;52:113-34. Difficult elbow fractures: pearls and pitfalls. O'Driscoll SW, Jupiter JB, Cohen MS, Ring D, McKee MD.