Elbow Fractures.

The elbow joint is made up of three bones; the humerus (upper arm bone), the radius and ulna (forearm bones). More specifically the elbow consists of portions of all three bones:

  • The distal humerus is the lower end of humerus. It forms the upper part of the elbow and is the spool around which the forearm bends and straightens.

  • The radial head is the dumbbell shaped end of the radius where it meets the elbow.

  • The olecranon is the part of the ulna that "cups" the lower end of the humerus, creating a hinge for elbow movement. The bony "point" of the olecranon can be easily felt beneath the skin.

    Depending on the severity of the injury any combination of the bones can be fractured and there may also be extensive soft tissue damage. Elbow fractures are often life changing injuries and due to their complexity, early expert assessment is advisable.

 
elbow fracture plates and screws treatment

How are elbow fractures diagnosed?

Following an injury; pain, difficulties lifting the arm, severe bruising, swelling and a bump or deformities around the elbow are all common symptoms. The majority of patients attend A&E straight away where the fracture is diagnosed.

  • X-rays can be obtained on the day of your consultation and will demonstrate the fracture pattern and the amount of displacement of the bone fragments. At a later stage of the injury, x-rays are very useful for monitoring fracture healing.

  • CT scans are usually required to assess in more detail the pattern of injury. They are also very useful if surgery is needed as they allow Mr Moverley to accurately plan your procedure.

Treatment options

Mr Moverley will tailor your treatment specifically to which parts of the elbow are broken and the displacement of the fragments, whilst taking into account your expectations and medical history.

Non-operative Management

Unless your elbow fracture is associated with a nerve or blood vessel injury it may usually possible to manage your fracture without surgery. If the fracture is undisplaced (the broken pieces are still touching) then non-operative treatment is often recommended. Possible non-operative options include:

  • A Sling to support the injured elbow and prevent movement at the fracture site, this may be needed for up to 6 weeks. A sling also provides excellent pain relief in the early stages after the injury, however using a sling for an extended treatment can lead to severe elbow stiffness in the long term.

  • Putting an ice pack on the injured area for 15-20 minutes may help reduce swelling, bruising, and pain.

  • Simple pain killers may help reduce pain and swelling.

  • Limiting certain activities such as lifting or driving, or movements such as reaching and pulling until the bone has healed.

  • A focused physiotherapy program to stretch the soft tissues around the elbow and to strengthen the muscles will help improve strength, flexibility, and range of motion in the injured arm and shoulder.

  • Smoking greatly reduces the likelihood of your proximal humerus fracture healing. If you do smoke you should try and quit immediately.

Surgical Management

Mr Moverley will discuss if surgery is necessary for your elbow fracture in the following cases:

  • Dislocated fractures, in which one of the bones of the elbow has dislocated from the joint.

  • Open fractures, in which the bone penetrates the skin.

  • Injuries to surrounding blood vessels and nerves.

  • Widely displaced fractures

  • Displaced fractures involving the joint surfaces disrupting the cartilage of the joint