Elbow Fracture

With three bones that are constantly moving your arm and turning your wrist, there are many opportunities for your elbow to fracture. Increasing the likelihood is the fact that the elbow is very good at one of its prime missions: extending the arm quickly to protect the body from impact, gallantly absorbing the force.

“With three bones that are constantly moving your arm and turning your wrist, there are many opportunities for your elbow to fracture.”

Symptoms

Symptoms of an elbow fracture include:

  • Swelling or bruising around the elbow
  • Intense pain accompanied by the inability to straighten the elbow
  • Pain while moving the elbow joint
  • In severe cases, a lack of stability between the three bones of the elbow

Causes

Making up the elbow joint are three bones (humerus, ulna, and radius), which are responsible for moving your forearm and turning your wrist. Any of these bones are at risk of fracturing, especially if you engage in vigorous sports or have developed osteoporosis due to age, nutritional deficiencies, or genetics. If your elbow is put under extreme force, any of these bones can fracture or even shatter into several pieces. Sometimes one of the bones will crack but remain in place. This means the bone is weakened but still in alignment.

Diagnosis

A doctor will perform a physical examination on the patient to assess the amount of swelling and bruising around the elbow and ask the patient about the type and severity of pain they are experiencing. The doctor will also perform a careful neurologic exam due to the close proximity of the nerves that control the muscles of our forearm and hand. The doctor might also decide to order an x-ray, MRI, or CT scan. If there is concern of a nerve injury, an electromyographic study (EMG) may be ordered.

Nonsurgical treatment options

An elbow fracture is something you cannot safely ignore. It requires immediate assessment by a doctor to decide whether surgery is needed. In some cases, bones can be repositioned without surgery—this is called a closed reduction procedure. Otherwise, surgery—a procedure called open reduction and internal fixation (ORIF)—may be required. Not everyone will be a candidate for ORIF, but your chances of needing the procedure are higher if your bones are out of alignment, have shattered into several pieces, or pierced through the skin. No matter which technique is appropriate to your injury, restoring the normal anatomy which allows an early range-of-motion program is essential for the future functionality of your arm.

A broken bone in the elbow becomes a more complicated problem if the trauma that shattered the bone also damaged the surrounding ligaments, tendons, and muscles. Sometimes there is even damage inflicted upon the vital nerves and blood vessels. With a significant fracture, you will most likely need surgery to ensure the bone heals efficiently and in proper alignment.

How surgery is performed

Open reduction is a technique during which the surgeon cuts through the skin and muscle to access the bone to mend it and return it to proper alignment. This is performed with general anesthesia and frequently a regional nerve block. The term “internal fixation” refers to the way your surgeon reconnects the broken bone, often using plates and screws.

“No matter which technique is appropriate to your injury, restoring the normal anatomy which allows an early range-of-motion program is essential for the future functionality of your arm.

Recovery time

After surgery, you will need to follow a course of physical therapy, supplemented by home exercises, to rebuild strength and flexibility in the muscles and ligaments and ensure maximum range of motion. Dr. Romeo will provide specific instructions to manage any post-op pain.

Results 

Most patients take approximately six weeks for their elbow fracture to fully heal. Afterward, they will continue to see improvement in their range of motion for at least six to twelve months.

After surgery, you can expect to wear a hinged elbow brace that will provide additional stability to your elbow. The hinged elbow brace will be gradually modified over the first four to six weeks to allow for a protected increase in range of motion. The main restriction after surgery is not being able to use your elbow to lift heavy things. You also will not be able to use it to push or pull, for example opening a door. The good news, however, is that you should be able to dress, bathe, and feed yourself with no issues.

FAQs

Will my elbow be permanently stiff or loose after a fracture?

It depends. After a fracture, the elbow will fill with blood and become very stiff and painful. As you recover from surgery, Dr. Romeo will guide you through the process of restoring your range of motion without compromising the healing of the fracture and soft tissues. Otherwise, the stiffness can become permanent. 


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For more information about causes and treatment of elbow fractures, please request an appointment with experienced Chicago orthopaedic surgeon Dr. Anthony Romeo. Call or email our office today to schedule your visit.

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