What is an elbow fracture?
An elbow fracture is a break in one or more of the three bones that make up the elbow joint. It is usually caused by an injury, when the elbow receives an impact, when the patient suffers a fall or a twist in the joint. In addition to the fracture, there may also be strains, dislocations or sprains. Fractures can be:
- Fissure of the bone: it is a stable break but there may be some risk.
- Displaced: when the two extremities of the broken bone are separated.
- Non-displaced: the bone is fractured but remains in place.
- Open, when the broken bone goes through the patient’s skin.
- Comminuted, when the bone is broken into many pieces.
The most common types of elbow fractures are:
- Fracture of the head and neck of the radius: the patient feels more pain when the forearm is rotated up and down with the palm of the hand. The treatment will depend on how broken the bone is and in how many fragments. If it is very complex it will be necessary to operate to repair the joint, to extract or to replace the head of the radius (in case there are many fragments).
- Olecranial fractures: they are usually displaced and surgery is required to realign the bones with pins, wires, plates or screws.
- Fractures of the distal humerus: these are typical in children and the elderly. They may be associated with nerve and artery injuries and should be well analyzed. Treatment is usually surgical with plates or screws.
Elbow fractures are usually caused by trauma to the joint.
Prognosis of the disease
Fractures of the elbow, ulna and radius are quite typical, especially in falls backwards and support with the hand and when there is a hyperextension of the elbow. Although it is not something very serious, they usually have a costly rehabilitation process in terms of recovery of mobility afterwards, especially in the extension movement of the joint.
Elbow fracture symptoms
Typical symptoms of an elbow fracture are:
- Pain and tenderness in the joint.
- Swelling and the possibility of bruising.
- Numbness in the elbow, arm and hand, as well as weakness.
- Inability and difficulty moving the arm.
- Deformity or bulging, that the arm does not have its normal shape.
In addition, a snapping sound may be heard at the time of the fracture. If there is a visible deformity, it means that the bones are out of place or the joint is dislocated.
Medical tests for elbow fracture
The trauma specialist should thoroughly evaluate the elbow injury. He/she will first check for skin wounds and examine the arm to see if the patient has less sensation. He will also evaluate problems when moving the arm. Some tests may be used to help with this:
- X-rays, to check for bone fractures. If fractures are not observed in the X-ray they can be located in the fat located in the interior of the elbow. According to the signs of the layer of fat they will be able to be necessary radiographies from other points.
- Computed Tomography (CT) or Magnetic Resonance Imaging (MRI): These are used to analyze the fractured part of the bone and to see if other tissues are affected. Contrast fluid may help to see the bones better.
What are the causes of an elbow fracture?
The most common causes of elbow, radius and ulna fractures are the result of a fall, a direct blow to the joint or a twist. Osteoporosis can also increase the risk of elbow fracture.
Can it be prevented?
Elbow fractures are difficult to prevent. However, the symptoms and possible pain of an elbow fracture can be improved by following the specialist’s recommendations. Specifically, the patient can:
- Elevate the elbow above the level of the heart to reduce inflammation and pain. It will be able to be helped placing the elbow on pillows and it is advisable to move the fingers, opening and closing them to avoid stiffness in the hand.
- Apply ice to the elbow to reduce pain and swelling, as well as possible tissue damage. It is important to cover the ice with a towel. It should be applied for 15-20 minutes every hour or so.
- Take some medication for pain, according to the specialist’s indications. The patient should not wait until the pain is very intense. The specialist should recommend the frequency of taking them, and is the one who should prescribe them.
- Physiotherapy and rehabilitation exercises. The physiotherapist will help the patient with exercises to improve the movement of the joint, as well as to recover the strength in the muscles.
Elbow fracture treatments
Elbow fractures usually heal with non-surgical treatment, such as a sling, cast or splint (when there is little risk of the bones moving out of place). In any case, the treatment will depend on the age of the patient and the movement he/she performs during the day. Thus, it is common to apply a cast in children because elbow stiffness is unlikely to occur, which is more common in adults. To avoid it, rehabilitation exercises will be done and various therapies with heat, ice, massages… will be applied.
In cases of more serious fractures, which are out of place or are unstable, surgery will probably be necessary. The intervention consists of replacing and stabilizing the pieces of bone, or removing them. When there is an open fracture and the skin has broken, it is very important to intervene urgently to clean the wound and the bone, and to reduce infection.
Which specialist treats it?
Who treats elbow fractures is the specialist in Traumatology. In particular those professionals who have specialized in the elbow joint are the ones who can best treat them.