What are the common causes of olecranon fractures. How are elbow fractures diagnosed and treated. What are the symptoms of a broken elbow. How long does it take for an olecranon fracture to heal. What are the potential complications of elbow fractures.

Understanding Olecranon Fractures: Anatomy and Causes

The olecranon, a bony prominence at the tip of the elbow, is a crucial component of the elbow joint. It forms part of the ulna, one of the three bones that constitute the elbow. Due to its exposed position, the olecranon is susceptible to fractures, which can significantly impact elbow function and mobility.

Olecranon fractures commonly occur due to:

• Direct falls onto the elbow
• Blunt force trauma from hard objects
• Vehicle collisions
• Falls on an outstretched arm with a tightly braced elbow

The severity of olecranon fractures can vary from minor cracks to complex, displaced fractures. In some cases, these injuries may be accompanied by damage to surrounding ligaments or result in open fractures, where bone fragments protrude through the skin.

Recognizing the Signs and Symptoms of an Olecranon Fracture

Identifying an olecranon fracture promptly is crucial for appropriate treatment. The most common symptoms include:

• Sudden, intense pain in the elbow
• Difficulty or inability to move the elbow
• Swelling over the elbow tip or back
• Bruising around the elbow, potentially extending to the shoulder or wrist
• Tenderness to touch
• Numbness in one or more fingers
• Pain during elbow movement or forearm rotation
• A sensation of joint instability

Are these symptoms always indicative of an olecranon fracture? While these signs strongly suggest a fracture, a proper medical evaluation is necessary for an accurate diagnosis, as similar symptoms can occur with other elbow injuries.

Diagnostic Procedures for Elbow Fractures

When a patient presents with suspected olecranon fracture, healthcare providers employ a systematic approach to diagnosis:

Physical Examination

The initial assessment involves a thorough physical examination, including:

• Inspection of the skin for cuts, swelling, blisters, or bruising
• Palpation of the elbow area to identify points of tenderness
• Evaluation of pulse at the wrist to ensure adequate blood flow
• Assessment of finger and wrist movement and sensation

Imaging Studies

To confirm the diagnosis and determine the extent of the fracture, imaging studies are essential:

• X-rays: Standard views of the elbow to visualize the fracture pattern
• CT scans: For more detailed imaging of complex fractures
• MRI: In cases where soft tissue damage is suspected

How do these diagnostic procedures help in treatment planning? The combination of physical examination and imaging studies provides crucial information about the fracture’s severity, displacement, and potential complications, guiding the selection of the most appropriate treatment approach.

Treatment Options for Olecranon Fractures

The treatment of olecranon fractures varies depending on the severity of the injury and the patient’s individual circumstances. Treatment options include:

Non-Surgical Management

For simple, non-displaced fractures, conservative treatment may be sufficient:

• Immobilization with a splint or cast
• Pain management with medications
• Regular follow-up to monitor healing progress

Surgical Intervention

Most olecranon fractures require surgical treatment, especially when bone fragments are displaced. Surgical options include:

• Open reduction and internal fixation (ORIF) with plates and screws
• Tension band wiring for smaller fractures
• Fragment excision and triceps advancement for comminuted fractures

What factors influence the choice between surgical and non-surgical treatment? The decision depends on factors such as fracture displacement, joint stability, patient age, overall health, and functional demands.

Rehabilitation and Recovery After Olecranon Fracture

Recovery from an olecranon fracture involves a structured rehabilitation process:

Immediate Post-Treatment Phase

• Pain and swelling management
• Immobilization to protect the healing fracture
• Gentle finger and wrist exercises to maintain circulation

Early Rehabilitation Phase

• Gradual introduction of passive range of motion exercises
• Isometric strengthening exercises
• Scar management techniques for surgical patients

Advanced Rehabilitation Phase

• Progressive active range of motion exercises
• Strengthening exercises for the elbow and surrounding muscles
• Functional activities to improve daily living skills

How long does the recovery process typically take? The duration of recovery varies but generally ranges from 3 to 6 months for full functional restoration. However, some patients may continue to experience improvements for up to a year post-injury.

Potential Complications and Long-Term Outcomes

While most olecranon fractures heal well with appropriate treatment, potential complications can occur:

• Infection, particularly in open fractures
• Nonunion or malunion of the fracture
• Hardware irritation requiring removal
• Stiffness and limited range of motion
• Post-traumatic arthritis
• Ulnar nerve irritation or injury

Can these complications be prevented or minimized? Many complications can be mitigated through proper initial treatment, careful adherence to rehabilitation protocols, and regular follow-up with healthcare providers. Early recognition and intervention for developing complications are crucial for optimal outcomes.

Prevention Strategies for Elbow Fractures

While not all elbow fractures can be prevented, certain strategies can reduce the risk:

• Wearing protective gear during sports and high-risk activities
• Maintaining good bone health through proper nutrition and exercise
• Fall-proofing living spaces, especially for older adults
• Practicing proper falling techniques in sports like skateboarding or martial arts

How effective are these prevention strategies? While they can significantly reduce the risk of elbow fractures, it’s important to remember that accidents can still occur. The key is to minimize risk factors where possible and be prepared to seek prompt medical attention if an injury does occur.

Advances in Olecranon Fracture Treatment

The field of orthopedic surgery continues to evolve, bringing new approaches to olecranon fracture treatment:

Minimally Invasive Techniques

Advancements in surgical techniques have led to the development of minimally invasive procedures for certain types of olecranon fractures. These approaches aim to reduce surgical trauma and potentially speed up recovery times.

Improved Fixation Devices

New designs in plates, screws, and other fixation devices offer better stability and reduced risk of hardware-related complications. These innovations can lead to improved outcomes and decreased need for secondary surgeries.

Biological Augmentation

The use of growth factors and other biological agents to enhance fracture healing is an area of ongoing research. These techniques hold promise for accelerating recovery and improving outcomes, especially in complex cases.

3D Printing and Custom Implants

Advancements in 3D printing technology allow for the creation of patient-specific implants and surgical guides. This customization can lead to more precise surgeries and potentially better functional outcomes.

How do these advancements impact patient care? These innovations offer the potential for more personalized treatment approaches, potentially leading to faster recovery times, improved functional outcomes, and reduced complication rates. However, long-term studies are still needed to fully establish their efficacy and safety.

Are there any emerging non-surgical treatments for olecranon fractures? While surgical intervention remains the gold standard for most displaced olecranon fractures, research into non-invasive treatments continues. Ultrasound therapy and other forms of biophysical stimulation are being explored as potential adjuncts to accelerate fracture healing, particularly in cases where surgery may be contraindicated.

Special Considerations in Pediatric Olecranon Fractures

Olecranon fractures in children present unique challenges and considerations:

Growth Plate Involvement

In pediatric patients, the presence of open growth plates (physes) adds complexity to fracture management. Injuries involving the growth plate require careful treatment to avoid growth disturbances.

Treatment Approach

Many pediatric olecranon fractures can be treated non-operatively due to children’s superior healing capacity and potential for remodeling. However, significantly displaced fractures may still require surgical intervention.

Long-Term Monitoring

Children with olecranon fractures often require longer follow-up periods to monitor for potential growth disturbances or functional limitations that may develop over time.

How does the management of pediatric olecranon fractures differ from adults? The primary differences lie in the consideration of growth plate involvement, the greater potential for non-operative management, and the need for long-term follow-up to ensure normal growth and development of the elbow joint.

Impact of Olecranon Fractures on Athletic Performance

For athletes, olecranon fractures can have significant implications:

Sport-Specific Considerations

The impact of an olecranon fracture varies depending on the sport. For example:

• Throwing athletes (e.g., baseball pitchers) may face challenges in regaining full function and performance
• Contact sport athletes may require additional protective measures upon return to play
• Gymnasts and weight lifters may need extended rehabilitation to regain the strength and stability necessary for their sports

Return to Play Protocols

The process of returning to competitive sports after an olecranon fracture typically involves:

1. Achieving full range of motion
2. Regaining strength comparable to the uninjured arm
3. Sport-specific training and conditioning
4. Gradual return to competition with close monitoring

What factors influence the timeline for return to sports after an olecranon fracture? The timeline varies based on the severity of the injury, the type of treatment received, the athlete’s healing progress, and the specific demands of their sport. Generally, return to full competitive activity can take anywhere from 3 to 6 months, with some high-level athletes requiring even longer.

Psychological Aspects of Olecranon Fracture Recovery

The psychological impact of an olecranon fracture should not be overlooked:

Emotional Challenges

Patients may experience a range of emotions during recovery, including:

• Frustration with temporary loss of independence
• Anxiety about recovery and return to normal activities
• Depression, particularly in cases of prolonged recovery or complications

Coping Strategies

Effective coping mechanisms can significantly impact recovery:

• Setting realistic goals and celebrating small milestones
• Engaging in activities that promote mental well-being
• Seeking support from family, friends, or support groups
• Consulting with mental health professionals when needed

How can healthcare providers address the psychological aspects of olecranon fracture recovery? Incorporating psychological support into the treatment plan, providing clear communication about the recovery process, and offering resources for mental health support can help patients navigate the emotional challenges of recovery more effectively.

Nutrition and Lifestyle Factors in Olecranon Fracture Healing

Proper nutrition and lifestyle choices play a crucial role in fracture healing:

Nutritional Considerations

Key nutrients that support bone healing include:

• Calcium and Vitamin D for bone mineralization
• Protein for tissue repair and collagen formation
• Vitamin C for collagen synthesis
• Zinc and copper for enzyme function in bone formation

Lifestyle Factors

Certain lifestyle choices can impact fracture healing:

• Smoking cessation to improve blood flow and healing
• Moderate alcohol consumption to avoid interference with bone metabolism
• Regular, appropriate exercise to stimulate bone formation
• Adequate sleep to support overall healing processes

How significant is the impact of nutrition and lifestyle on fracture healing? While proper medical treatment remains paramount, optimizing nutrition and adopting healthy lifestyle habits can potentially accelerate healing, reduce complications, and improve overall outcomes in olecranon fracture recovery.

Future Directions in Olecranon Fracture Management

The field of olecranon fracture management continues to evolve, with several promising areas of research and development:

Gene Therapy

Researchers are exploring the potential of gene therapy to enhance bone healing. This approach involves delivering specific genes to fracture sites to stimulate bone formation and accelerate the healing process.

Nanotechnology

The application of nanotechnology in orthopedics holds promise for improving fracture fixation and promoting bone regeneration. Nanoparticle-based drug delivery systems and nanostructured implant surfaces are areas of active investigation.

Artificial Intelligence and Machine Learning

AI and machine learning algorithms are being developed to assist in fracture diagnosis, treatment planning, and prediction of outcomes. These tools have the potential to enhance decision-making and personalize treatment approaches.

Regenerative Medicine

Advancements in stem cell therapy and tissue engineering offer new possibilities for enhancing fracture healing and addressing challenging cases such as nonunions.

What potential impact could these future developments have on olecranon fracture treatment? These innovations have the potential to revolutionize fracture management by offering more personalized, efficient, and effective treatment options. They may lead to faster healing times, improved functional outcomes, and reduced complication rates. However, extensive research and clinical trials are still needed to fully realize and implement these advancements in clinical practice.

As our understanding of olecranon fractures continues to grow and technology advances, the future of treatment for these injuries looks promising. Patients can expect more tailored treatment approaches, potentially faster recovery times, and improved long-term outcomes. However, it’s important to remember that the fundamental principles of careful diagnosis, appropriate treatment selection, and diligent rehabilitation will remain crucial components of successful olecranon fracture management.

Elbow (Olecranon) Fractures – OrthoInfo

An olecranon (oh-LEK-rah-nun) fracture is a break in the bony tip of the elbow. This pointy segment of bone is part of the ulna, one of the three bones that come together to form the elbow joint.

The olecranon is positioned directly under the skin of the elbow, without much protection from muscles or other soft tissues. It can break easily if you experience a direct blow to the elbow or fall onto the tip of the elbow. A fracture can be very painful and make elbow motion difficult or impossible.

Treatment for an olecranon fracture depends upon the severity of the injury. Some simple fractures can be treated by wearing a splint until the bone heals. In most olecranon fractures, however, the pieces of bone move out of place when the injury occurs. For these fractures, surgery is required to restore both the normal anatomy of the elbow and motion in the joint.

The olecranon (arrow) is the bony point of the elbow.

Your elbow is a joint made up of three bones:

• The humerus (upper arm bone)
• The radius (forearm bone on the thumb side)
• The ulna (forearm bone on the pinky side)

The elbow joint bends and straightens like a hinge. It is also important for rotation of the forearm; that is, the ability to turn your palm up (like accepting change from a cashier) or palm down (like typing or playing the piano).

The elbow consists of portions of all three bones:

• The distal humerus is the lower end of the 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 knobby end of the radius where it meets the elbow. It glides up and down the front of the distal humerus when you bend your arm and rotates around the ulna when you turn your wrist up or down.
• 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 easily be felt beneath the skin because it is covered by just a thin layer of tissue.

The elbow is held together by its bony architecture, as well as ligaments, tendons, and muscles. Three major nerves cross the elbow joint.

(Left) The bones of the elbow. The olecranon is the tip of the elbow and is part of the ulna.

(Right) The major nerves and ligaments are highlighted.

Olecranon fractures are fairly common. Although they usually occur on their own with no other injuries, they can also be part of a more complex elbow injury.

In an olecranon fracture, the bone can crack just slightly or break into many pieces. The broken pieces of bone may line up straight or may be far out of place (displaced fracture).

In some cases, the bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the bone. This is called an open fracture. Open fractures are particularly serious because once the skin is broken, infection in both the wound and the bone are more likely to occur. Immediate treatment is required to prevent infection.

Olecranon fractures are most often caused by:

• Falling directly on the elbow
• Receiving a direct blow to the elbow from something hard, like a baseball bat, or a dashboard or car door during a vehicle collision.
• Falling on an outstretched arm with the elbow held tightly to brace against the fall. In this situation, the triceps muscle, which attaches to the olecranon, can pull a piece of the bone off of the ulna. Injuries to the ligaments around the elbow may occur with this type of injury, as well.

An olecranon fracture usually causes sudden, intense pain and can prevent you from moving your elbow. Other signs and symptoms of a fracture may include:

• Swelling over the tip or back of the elbow.
• Bruising around the elbow. Sometimes, this bruising travels up the arm toward the shoulder or down the forearm toward the wrist.
• Tenderness to the touch.
• Numbness in one or more fingers.
• Pain with movement of the elbow or with rotation of the forearm.
• A feeling of instability in the joint, as if your elbow is going to pop out.

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Physical Examination

Your doctor will talk with you about your medical history and general health and ask about your symptoms. They will then examine your elbow to determine the extent of the injury. During the exam, your doctor will:

• Check your skin for cuts, swelling, blistering, and bruising. In severe fractures, bone fragments can break through the skin, increasing the risk of infection.
• Palpate (feel) all around your elbow to determine if there are any other areas of tenderness. This could indicate other broken bones or injuries, such as a dislocated elbow.
• Check your pulse at the wrist to ensure that there is good blood flow to your hand and fingers.
• Check to see that you can move your fingers and wrist, and can feel things with your fingers.

Although you may have pain only at the elbow, your doctor may also examine your shoulder, upper arm, forearm, wrist, and hand to ensure that you do not have any other injuries.

X-rays

X-rays provide images of dense structures, such as bones. Your doctor will order X-rays of your elbow to help diagnosis your fracture. Depending on your symptoms, the doctor may also order X-rays of your upper arm, forearm, shoulder, wrist, and/or hand to determine whether you have other injuries.

This X-ray taken from the side shows an olecranon fracture in which the pieces of bone have moved out of place (displaced).

Reproduced from Konda SR: Fractures around the elbow, in Egol KA, Gardner MJ, eds: Let’s Discuss Management of Common Fractures. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2016, pp. 17-30.

While you are in the emergency room, your doctor will apply a splint (like a cast) to your elbow, and give you a sling to help keep the elbow in position. Immediate treatment may also include:

• Applying ice to reduce pain and swelling
• Medications to relieve pain

Your doctor will determine whether your fracture requires surgery. Many olecranon fractures will require surgery.

Nonsurgical Treatment

If the pieces of bone are not out of place (displaced), a fracture can sometimes be treated with a splint to hold the elbow in place during healing. During the healing process, your doctor will take frequent X-rays to make sure the bone has not shifted out of place.

You will typically wear a splint for 6 weeks before starting gentle motion. If the fracture shifts in position during this time, you may need surgery to put the bones back together.

(Left) The doctor will apply a splint that runs from near your shoulder all the way to your hand. (Right) An elastic bandage is applied to help keep the splint in place.

Surgical Treatment

Surgery is usually required for olecranon fractures in which:

• The bones have moved out of place (displaced fracture)
• Pieces of bone have punctured the skin (open fracture)

Surgery for olecranon fractures typically involves putting the broken pieces of bone back into position and preventing them from moving out of place until they are healed.

Because of the increased risk of infection, open fractures are scheduled for surgery as soon as possible, usually within hours of the diagnosis. Patients are given antibiotics by vein (intravenous) in the emergency room, and may receive a tetanus shot. During surgery, the cuts from the injury and the surfaces of the broken bone are thoroughly cleaned out. The bone will typically be repaired during the same surgery.

Surgical Procedures

Open reduction and internal fixation. This is the procedure most often used to treat olecranon fractures. During the procedure, the bone fragments are first repositioned (reduced) into their normal alignment. The pieces of bone are then held in place with screws, wires, pins, or metal plates attached to the outside of the bone.

Some common methods of internal fixation are shown below.

An olecranon fracture may be held together with pins and wires. This is called a tension band.

(Left) Reproduced from Boyer MI, Galatz LM, Borrelli J, Axelrod TS, Ricci WM: Intra-articular fractures of the upper extremity: new concepts in surgical treatment, in Ferlic DC, ed: Instr Course Lect 52. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003, pp. 591-605.

(Left) A single screw, placed into the center of the bone, may be used to keep the fractured bones together.
(Right) Plate(s) and screws may be used to hold the broken bones in place.

Bone graft. If some of the bone has been lost through the wound or is crushed, the fracture may require bone graft to fill the gaps. Bone graft can be taken from a donor (allograft) or from another bone in your own body (autograft). In some cases, an artificial material can be used instead of bone graft.

Complications of Surgery

There are risks associated with any surgery. If your doctor recommends surgery, they think that the possible benefits outweigh the risks.

Potential complications include:

Elbow stiffness. One of the most common problems patients face after any fracture around the elbow is stiffness. It is very important to begin physical therapy as directed to avoid elbow stiffness. In most cases, the 

Infection. There is a risk of infection with any surgery. Your doctor will take specific measures to help prevent infection.

Hardware irritation. A small percentage of patients may experience irritation from the metal implants used to repair the fracture.

Damage to nerves and blood vessels. There is a minor risk of damage to nerves and blood vessels around the elbow. This is an unusual side effect.

Nonunion. Sometimes, a fracture does not heal. The fracture may pull apart and the screws, plates, or wires may shift or break. This can occur for a number of reasons, including:

• The patient does not follow directions after surgery.
• The patient has a health problem, such as diabetes, that slows healing. Smoking or using other tobacco products also slows healing. Learn more: Smoking and Surgery
• If the fracture was associated with a cut in the skin (open fracture), healing is often slower.
• Infections can also slow or prevent healing.

If the fracture fails to heal, you may need further surgery.

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Pain Management

Most fractures hurt moderately for a few days to a couple of weeks. Many patients find that using ice, elevation (holding their arm up above their heart), and non-prescription pain medications are sufficient to relieve pain.

If your pain is severe, your doctor may suggest a prescription-strength medication, such as an opioid, for a few days.

Be aware that although opioids help relieve pain after surgery, opioid dependency and overdose have become critical public health issues. For this reason, opioids are typically prescribed for a short period of time. It is important to use opioids only as directed by your doctor and to stop taking them as soon as your pain begins to improve.

Rehabilitation

Whether your treatment is surgical or nonsurgical, full recovery from an olecranon fracture requires a good effort at rehabilitation.

Recovery After Nonsurgical Treatment

Because nonsurgical treatment can sometimes require long periods of splinting or casting, your elbow may become very stiff. For this reason, you may need a longer period of physical therapy to regain motion.

During rehabilitation, your doctor or a physical therapist will provide you with exercises to help:

• Improve range of motion
• Decrease stiffness
• Strengthen the muscles within the elbow

You will not be allowed to lift, push, or pull anything with your injured arm for a few weeks. Your doctor will talk with you about specific restrictions.

Recovery After Surgical Treatment

Depending on the complexity of the fracture and the stability of the repair, your elbow may be splinted or casted for a short period of time after surgery.

Physical therapy. Patients will usually begin exercises to improve motion in the elbow and forearm shortly after surgery, sometimes as early as the next day. It is extremely important to perform the exercises as often as directed. The exercises will only make a difference if they are done regularly.

Restrictions. You will not be allowed to lift heavy objects with your injured arm for at least 6 weeks. You will also be restricted from pushing and pulling activities, such as opening doors or pushing up while rising from a chair. You may be allowed to use your arm for bathing, dressing, and feeding activities. Your doctor will give you specific instructions. They will also let you know when it is safe to drive a car.

Even with successful treatment, some patients with olecranon fractures may experience long-term complications.

Loss of Motion

In some cases, a patient may not be able to regain full motion in the affected elbow. In most of these cases, the patient cannot fully extend or straighten their arm. Fortunately, the loss of a few degrees of straightening does not usually affect the overall function of the arm. Patients who have significant loss of motion may require intensive physical therapy, special bracing, or further surgery. This is uncommon for olecranon fractures.

Posttraumatic Arthritis

Posttraumatic arthritis is a type of arthritis that develops in a joint after an injury. Even when your bones heal normally, the cartilage lining the joint surfaces can be damaged, leading to pain and stiffness over time.

Posttraumatic arthritis is a relatively common complication of olecranon fractures. It can occur shortly after the fracture occurs or can take years to develop. Some patients with posttraumatic arthritis may need further surgery to relieve their symptoms. However, for many patients, there is little pain and no need for further treatment.

Most patients can return to their normal activities within about 4 months, although full healing can take more than a year. Recovering strength in your arm often takes longer than might be expected.

Although X-rays may show that the fracture has healed completely, some patients report that they still have limitations in movement. These patients will usually continue to improve over time.

Questions to Ask Your Doctor

If you experience an olecranon fracture, here are some questions you may wish to ask your doctor:

• When can I start moving my elbow?
• How soon can I resume my normal activities?
• What factors will prolong or delay healing?
• If I have to have surgery, what are the benefits and risks?
• What will my recovery be like?

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Broken Elbow

Written by WebMD Editorial Contributors

• Broken Elbow Overview
• Broken Elbow Causes
• Broken Elbow Symptoms
• When to Seek Medical Care
• Exams and Tests
• Broken Elbow Treatment Self-Care at Home
• Medical Treatment
• Medications
• Surgery
• Other Therapy
• Next Steps
• Prevention
• Outlook
• Synonyms and Keywords
• More

Elbow injuries are common in both adults and children. Early recognition and treatment of an elbow injury can reduce the risk of complications and later disability. Any serious injury of the elbow deserves medical attention.

• Your elbow is a complex joint formed by 3 bones:
  • The humerus is a single bone in your upper arm that runs from your shoulder to your elbow.
  • The radius and ulna, bones of your forearm, run from the elbow to the wrist.
  • Ligaments, muscles, and tendons maintain your elbow’s stability and allow joint movement.
     
• A normal elbow joint allows these motions:
  • Flexion, or bending
  • Extension, or straightening
  • Rotation, turning your palm up and down
     
• Serious injuries, such as fractures (a bone break) and dislocations, can damage the bones and other structures of your elbow, resulting in problems with movement, blood vessel function, and nerve function. In children, fractures can affect the growth and development of the bones. This is because children have many bone “growth centers,” a part of the bone where bone growth takes place. As bone growth continues throughout childhood, if one of these “growth centers” is involved in a fracture, it can affect bone development.
   
• An elbow fracture is a break that involves 1 or more of the 3 arm bones where they work together to form the elbow joint.

You can injure your elbow in a variety of ways, from overuse (athletic injuries) to an acute traumatic event (a fall or direct blow). Some common events that result in elbow fractures include:

• When you fall backward, off a snowboard for example, you may attempt to brace the fall with your arm outstretched and your hand open.
• High-energy trauma can occur in an automobile or motorcycle collision.
• A direct blow on the elbow can cause a break when you fall off a skateboard or bicycle and land directly on an elbow.
• Sideswipe injury occurs when an elbow is struck while you are resting your elbow out an open car window.
• Any other direct injury to the elbow, wrist, hand, or shoulder can affect the elbow.

If your elbow shows any of the following signs you may have a fracture or another injury that needs medical attention.

• Swelling of your elbow or in the area immediately above or below your elbow
• Deformity of your elbow, or the areas near your elbow
• Discoloration, such as bruising or redness of your elbow
• Difficulty moving your elbow through its complete range of motion
   
  • Flexion and extension: You should be able to bend your elbow so that you can touch your shoulder with your fingertips. You also should be able to fully straighten your arm.
  • Inward and outward rotation: When holding your arm at your side with your elbow flexed (bent) at 90°, you should be able to rotate your hand outward so that your palm faces the ceiling. In this same position, you should be able to rotate your hand inward so that your palm faces the floor.
     
• Numbness, decreased sensation, or a cool sensation of your forearm, hand, or fingers
   
  • Three major nerves-the median, radial, and ulnar nerves-travel through your elbow. A serious injury may damage these nerves.
  • Many blood vessels also pass through your elbow. These important vessels may become injured or compressed when trauma or swelling occurs.
     
• A cut, or open wound, on the elbow after a traumatic injury
• Severe pain after an elbow injury
• A “tight sensation” in the area of your elbow or forearm

An elbow fracture carries the risk of potentially serious and disabling complications. If you think your elbow may be fractured, you should seek medical attention at a hospital’s emergency department immediately.

If you have only mild swelling, and no bruising, open wounds, or loss of feeling, you may consider calling a doctor prior to seeking emergency medical attention.

If your elbow shows any of the following problems after an injury to your arm, you should go to an emergency department.

• You have swelling at or near the elbow.
• You notice any deformity of the elbow or the areas near the elbow.
• If you have any doubts, compare your injured elbow to your uninjured one. If you have a new lump or bump, go to the emergency department.
• You hear or feel grinding, popping, or clicking as you move your elbow, wrist, or hand.
• Your elbow “catches” at the joint.
• Your normal elbow motion becomes limited.
• You see any discoloration of the elbow or areas near the elbow. A bluish, purplish, or blackish color may mean you are bleeding into, or near, your elbow. A reddish color may signal infection.
• You notice any numbness or tingling of any part of your arm, for instance, a “funny bone” feeling that doesn’t go away
• Your forearm, wrist, or fingers feels “dead” and difficult or impossible to move normally.
• You have any significant pain in your elbow, forearm, wrist, or hand.
• You notice any color or temperature change in your forearm, wrist, or hand.
• Your wrist or hand is pale, cool, or bluish. You may have a blockage of blood flow in your injured elbow.
• You are bleeding around the elbow area.
• You should be able to easily perform the following motions without pain:
   
  • Fully straighten your elbow
  • Fully bend it so that your fingertips touch your shoulder
  • Turn your palm completely toward the ceiling and toward the floor

The doctor may perform the following procedures in evaluating your broken elbow:

• The doctor will generally want to know your overall health history. Some of the questions will ask for this information:
  • Your age
  • Your handedness (Are you right-handed or left-handed?)
  • Your profession
  • Your level of activity (Are you an athlete or a desk worker?)
  • The surgeries and injuries you have had, particularly on your elbow or your hand
  • The medical illnesses or conditions you have had (Illnesses or medical conditions that may affect bones, joints, ligaments, tendons, muscles, nerves, and blood vessels are very important. Problems you have had with bleeding or healing are important also.)
  • The medical illnesses or conditions you now have
  • The medications you take
  • The medication allergies you have
  • The social habits you have (whether you smoke cigarettes or drink alcohol)
• The doctor also will ask specific questions about your injury.
  • What caused your injury? For example, did you fall or did something hit your elbow? If you fell, was it onto your hand or directly onto your elbow?
  • When did the injury occur?
  • When did your symptoms begin?
  • What symptoms have you noticed? For example, have you had pain, or pain and swelling, or swelling and discoloration?
• The doctor will perform a limited physical examination, paying particular attention to your injured arm.
  • The doctor will probably check your heart, lungs, and abdomen.
  • The doctor may also check your head, neck, back, and uninjured arms and legs. Most of this examination is to make sure that no other, more serious, injuries or conditions exist. Sometimes people in a great deal of pain from a broken elbow do not even notice that they have other injuries.
• The doctor may order basic x-rays. Depending on your unique health history and your treatment needs, the doctor may order additional laboratory tests or specialized x-rays.
  • Sometimes elbow injuries cause so much pain that a full examination is impossible. If this is the case, the doctor first may choose to look at your elbow without moving it or touching it.
  • The doctor may examine your hand and wrist to make sure that blood vessels and nerves are working properly.
  • The doctor then may decide to treat your pain and get some x-rays. Often after pain is relieved (by splinting or giving pain medications), a more complete and reliable examination is possible.
  • Basic elbow x-rays are taken from the front and side. Additional x-rays, taken at 2 different angles, also are routine.
  • In children, the doctor may take x-rays of the other, uninjured, elbow. Children’s elbows are not completely formed of bone. Growing cartilage, which later forms bone, may be mistaken for a broken bone. Comparing x-rays of injured and uninjured elbows may help the doctor make a correct diagnosis.
  • Other images that are like x-rays-ultrasound, CT scan, and MRI-may provide a more complete look at the injured elbow. It is unusual, but not unheard of, for these tests to be done in the emergency department.
• Laboratory tests generally aren’t needed for people with broken elbows. If you are taking certain medications, have certain health conditions, or require an operation to repair your broken elbow, then, lab tests may be done.
• If your doctor is concerned that the artery that runs by the elbow has been cut, an arteriogram may be recommended.
  • In this test, the doctor puts dye into the artery to see if it is damaged.
  • A damaged artery may need to be surgically repaired because it supplies all the blood to the wrist and hand.

Seek medical attention if you think you have broken your elbow. There is no home care. While seeking medical attention, however, here are some first aid tips that are important to remember:

• If you have an open wound, cover it with a clean bandage. If you are bleeding, apply firm pressure and raise your arm.
• Apply an ice pack or cool compress to the swollen area.
• Call for emergency help or get someone to call for emergency help immediately.
• If emergency help is not available immediately, or if you are transporting a person with a suspected broken elbow, immobilize the fracture as much as possible. Even a cardboard box, cut to the right size and shape, can be used as a splint.
• Do not attempt to straighten a broken bone. Allow a doctor or trained person to do that.
• Do not attempt to push a broken bone back into place if it is sticking out of the skin. Adjusting an arm that appears deformed may worsen the damage to bones or other structures within the elbow.

Treatment of a broken elbow depends on the type of injury that you have suffered. Your treatment may be as simple as elevating your splinted arm, applying ice to any swollen areas, and taking pain relievers. Treatment can also include operations to repair bones, nerves, and blood vessels. Children and adults usually have different types of elbow injuries. They also heal in very different ways. For these reasons, different treatments are often used for adults and children with broken elbows.

• A wide variety of pain relievers are available.
   
  • Oral medications are usually used for mild pain.
  • Injections, either into a muscle or into a vein (by IV), are used for moderate to severe pain.
     
• Medication can be put directly into the elbow joint to relieve pain or can be given by injection or IV.
   
  • If your elbow is dislocated or broken and needs to be reset, medications also can be used to help this process.
  • These medications relieve pain extremely well and although they may cause sedation (sleepiness), they allow muscles to relax and help a great deal while the doctor works on the elbow.
  • After receiving these medications and having their elbow reset, many people awaken to find their elbow has been repaired and splinted.

Sometimes an operation to repair your broken elbow is the best choice. This is particularly true if you have an open, or compound (a fracture in multiple pieces), elbow injury.

•  
  • An open elbow injury means that 1 or more of the bones at the elbow has come through the skin.
  • Not only does the bone need to be put in place, but it also needs to be thoroughly cleaned so infection does not occur. This is best done in an operating room.

Elbow injuries that damage nerves and blood vessels often need to be fixed in the operating room. Medical researchers have found that certain types of broken elbows heal better if they are repaired in the operating room. Your doctor will discuss the treatment options with you and help you make the best choice.

• If your elbow joint is filled with blood or other fluid, the joint can be drained in the emergency department.
   
  • Blood or other fluid drained from the elbow may suggest a particular diagnosis to the doctor.
  • Draining this fluid may relieve pressure and pain in the elbow.
     
• Splints, slings, and casts will be applied.
   
  • Doctors use splints after many different types of elbow injuries. Doctors usually make splints of plaster. They typically place splints on the back of your arm and do not completely encircle it with the splint material. Splints are designed to hold your elbow in one particular position.
  • Splints for broken elbows usually run from near your shoulder all the way to your hand. They prevent the elbow from bending or the hand from turning. Such motions may disturb a healing fracture or dislocation of the elbow.
  • The doctor may provide a sling so your heavy splinted arm can rest comfortably. Your doctor may ask you to remove the sling at home and elevate your arm above your head. Elevating the arm relieves swelling. This is very important especially during the first few days after an elbow injury when swelling may press on nerve and blood vessels in your elbow or forearm.
  • Doctors rarely apply casts to freshly injured elbows. A cast, unlike a splint, completely encircles the arm. If swelling occurs underneath a cast, the swelling may cause damage to nerves and blood vessels.
     
• Resetting broken elbows: If a bone in your elbow is broken or the elbow is out of joint, your doctor may need to reset the bones. This is done for a variety of reasons.
   
  • Putting the bones back in their proper positions may greatly relieve pain.
  • Resetting bones also allows proper healing to begin.
  • Sometimes broken bones press on, or cut, nerves or blood vessels. Moving the bones to their normal positions may stop this damage.
  • If the bones of your elbow need to be reset, medications are available to relieve the pain and anxiety you may feel.

Follow-up

It is extremely important to follow your doctor’s medical advice exactly if you have a broken elbow. Once injured, the elbow is not a “forgiving” joint as it heals. To get the best possible result after you’ve broken your elbow, pay attention to the advice your doctor gives you. Keep all follow-up appointments with your doctor.

Following are some of the common things you may be told after your first visit for your broken elbow:

• Use medications to reduce pain and swelling.
• Elevate your arm to reduce pain and swelling.
• Leave your splint or cast in place. Take care of your cast or splint.
• Take antibiotics to treat infection, if prescribed, or to reduce the chance of getting an infection.
• Return to the emergency department immediately if you notice any of the following:
   
  • Your hand is cold.
  • Your hand is pale or blue.
  • Your hand is numb, tingling, or “dead” feeling.
  • Your forearm hurts if you move your wrist, hand, or fingers.

Most broken elbows stem from trauma-falls, sports injuries, motor vehicle crashes. The same common-sense things you would do ordinarily to prevent accidents will help prevent elbow injuries.

• In automobiles
  • Obey the rules of the road and drive defensively.
  • Always wear your seat belts while driving and as a passenger.
  • Don’t drink alcohol and drive.
  • Don’t drive a vehicle if you’ve taken medicines or drugs that may make you sleepy.
  • Children always should be in proper child restraint devices.
  • Don’t drive with your arm propped on the window or hanging out of the car window.
     
• At home
  • Remove household items that may cause you to trip and fall. Some common tripping hazards are power cords, small rugs, and footstools.
  • Wipe up spills and deal with any slick floors that might cause a trip and fall.
  • Try to keep walks and driveways ice-free in winter.
     
• While exercising or playing sports
  • Don’t exercise, practice, or participate if you are overly fatigued. Injuries tend to happen when you are tired.
  • Don’t continue an activity if you are having elbow pain.
  • Always wear proper protective gear while playing sports.

The elbow is a very complex joint. Sometimes it is not very “forgiving” after it is injured. That is, the joint may develop certain problems. The way your elbow heals after it is broken depends on your age and medical condition at the time of your injury as well as the type of injury you have.

Certain types of elbow injuries are associated with particular types of problems as they heal. Children tend to heal better than adults. It is important to realize that many broken elbows heal without any problems. Your doctor will be able to advise you as your elbow heals.

Following are some of the more common problems with broken elbows:

• Infection: Open injuries-when one of the elbow bones comes through the skin-have a higher infection risk. Bacteria can then enter the bone or joint and cause an infection.
   
  • Doctors try to prevent infection by using sterile techniques in the operating room.
  • They also attempt to wash away bacteria on or near open injuries.
  • Antibiotics can be used to treat infections as well.
     
• Stiffness: Many elbow injuries result in elbow stiffness. The injured elbow may not flex, extend, or turn as much as it once did. This usually is a problem for adults rather than for children.
   
• Nonunion: A broken bone that does not grow back together is called nonunion. This can happen with certain types of elbow fractures. Nonunion of a broken elbow can be treated by replacing the elbow with an artificial joint or by bone grafting. Bone grafting involves placing additional bone around the area of the nonunion.
   
• Malunion: Malunion occurs when healing bones grow back together in an abnormal way. The bone may be bent or twisted. An operation may be required to fix this problem.
   
• Abnormal bone growth: A broken bone repairs itself by forming new bone. As a broken elbow heals, this new bone may form in areas where bone does not usually grow.
   
• Arthritis: Arthritis literally means joint inflammation. Most people think of arthritis as painful joints. After a severe injury, people can develop a type of arthritis that may make a joint painful and stiff. Sometimes this can become worse with cold weather or overuse.
   
• Nerve damage: The 3 nerves that run through the elbow can be cut, compressed, or pulled in an elbow injury. The resulting nerve damage may be temporary or permanent. Swelling after an elbow injury can press on nerves causing damage.
   
• Hardware problems: Doctors sometimes repair broken elbows with wires, pins, screws, plates, and other pieces of hardware. If any of this hardware moves, it may cause pain or unsightly bumps under your skin. If this occurs, the hardware may need to be removed.
   
• Blood vessel damage: A large artery runs very near your elbow joint to supply blood to the forearm, wrist, and hand. Certain elbow injures may cut or compress this artery. Sometimes resetting the broken elbow will relieve pressure on the artery. Sometimes you may need an operation.

fractured elbow, injured elbow, swollen elbow, elbow trauma, broken elbow

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fracture, dislocation, sprain, inflammation, arthritis / arthrosis, hygroma – Treatment and recovery

The elbow is a unique combination of three bones: the humerus, radius and ulna. This is a complex combined joint, which consists of three simple joints: humeroulnar, humeroradial, proximal radioulnar. All of them are united by one common capsule and joint bag (cavity). Inside the joint capsule, synovial fluid is constantly produced, which serves as a lubricant for the rubbing articular surfaces and nutrition for the anatomical parts. The ends of the bones are covered with a layer of periosteum, which helps protect and renew bone tissue, and also facilitates the flow of nutrients from the synovial fluid. All articular surfaces are covered with articular cartilage. The elbow joint is securely reinforced with ligaments and protected by a good muscular frame. These features allow you to perform four types of movements: extension and flexion, supination (rotation of the forearm at the elbow joint, in which it is possible to turn the hand palm up) and pronation (rotation of the forearm at the elbow joint, in which it is possible to turn the hand palm down). It is worth noting that the end of the ulna from above has an olecranon, resembling a hook in shape. The triceps muscle of the shoulder is attached to it. Fracture of this process is a fairly common injury.

Types of damage

The following categories of diseases are characteristic of the elbow joint:

• Traumatic
  • Bruises. The most common bruises are of the olecranon, periarticular tissues, condyles of the shoulder and ulnar nerve
  • Ligament sprains
  • Dislocations. There are: isolated dislocation and pronation subluxation of the radial head; dislocations of the forearm backwards, anteriorly, inwards, outwards; divergent dislocations with rupture of the proximal articulation and divergence of the bones of the forearm to the sides
  • Fractures of the bones of the elbow joint according to the nature of the damage can be divided into:
    • intra-articular;
    • periarticular;
    • closed;
    • open;
    • no offset;
    • with displacement of fragments (displacement of bone fragments most often occurs with fractures of the olecranon)
• Inflammatory
  • Epicondylitis (“tennis elbow”) is an inflammatory and degenerative disease that affects the tendons in the area of ​​the elbow joint due to chronic overload of the muscles of the forearm.
  • Styloiditis is a dystrophic-inflammatory process in the place where the tendon is attached to the process of the ulna.
  • Bursitis – inflammation of the joint capsule, which is located on the back of the elbow
  • Neuritis – ailments resulting from pinched nerve endings
  • Elbow tendinitis – inflammation in the tendons of the ulnar end of the triceps muscle
  • Arthritis – an acute inflammatory process in the articular cartilage and capsule without gross structural changes in the joint
• Arthrosis
  • Osteoarthritis is a dystrophic-degenerative disease of the cartilage and bone tissue of the joint.

Symptoms of pain

The main symptom of elbow disease is pain.

Traumatic group of injuries is characterized by the following signs:

• Stinging pain at the moment of injury
• Edema and hematoma in the area of ​​the elbow joint
• Elbow deformity
• Restriction in arm movements, partial or complete loss of limb function
• Or pathological mobility and the possibility of atypical movements for the elbow
• Numbness or tingling in the forearm, wrist, hand
• Squeak or click when moving the elbow
• Any discoloration of the skin in the affected area
• Perceptible protrusion of bone fragments under the surface of the skin

If any of the above symptoms should immediately seek help in the Department of Traumatology.

Which doctor to contact

To make an accurate diagnosis and prescribe the right treatment, you need to seek help from the following specialists:

• Traumatologist, orthopedist
• Surgeon
• Rheumatologist
• Neurologist

Highly qualified specialists are ready to receive you at the NCC Clinic No. 2 (Central Clinical Hospital of the Russian Academy of Sciences) in Moscow. You can make an appointment by phone +7 (499) 400-47-33

Diagnostics

Diagnostic activities include:

• Medical examination (palpation of the elbow joint area)
• Medical history taking
• Clinical and biochemical blood tests
• Urinalysis
• Ultrasound of elbow joints
• X-ray of the hand (two views)
• Computed tomography
• MRI

Treatment options

Treatment largely depends on the type and nature of the fracture in the elbow joint. Non-displaced fractures (such as those of the olecranon) can be treated conservatively by applying a fixing plaster cast for several weeks. If there is a displacement of the joint, then the issue of surgical intervention is decided. To do this, carry out the reposition of fragments (closed or open). With open comparisons, surgical fixation of fragments is mandatory, this operation is called osteosynthesis. Osteosynthesis is the connection of bone fragments with the help of special fixing means (bone grafts or metal structures). If fractures of the articular part of the humerus are fragmented, then it is possible to replace the elbow joint with a prosthesis. To restore the function of the elbow joint in deforming arthrosis, as well as in congenital and acquired deformities and contractures of other etiologies, osteotomy is currently performed. Osteotomy is a surgical operation that helps to eliminate the deformity of the elbow joint or improve the function of the musculoskeletal system by artificial fracture with further fixation to give a functionally advantageous position. After any surgical intervention, the patient is prescribed rehabilitation measures, compiled by the attending physician individually for each.

Fracture (fracture) of the elbow: causes, symptoms, signs, treatment, diagnosis, prevention

03/29/2016

Symptoms
Joint pain

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Overview

The bone at the top of the elbow is called the olecranon; it is thin, so it breaks easily during a fall or a direct blow to this area. The injured elbow is mostly immobilized by applying a cast or bandage, and it heals over time. However, in severe injuries, surgery is possible to reposition and fix the broken bone.

What to expect

Your doctor will examine your elbow, put a splint on it to immobilize it, and bandage your arm. Most elbow injuries heal on their own, but severe injuries require surgery. Children, who most often injure their elbows, usually recover without problems, and adults can lose some range of motion, although not so much that it interferes with daily activity. Full restoration of the integrity of the bone can take about 6 months or longer.

Condition may worsen due to

Postponement of medical care.

Diagnosis

The doctor will examine your elbow and the area of ​​the injury, checking it for pain and tenderness. He may also ask you to move your fingers, wrist, arm, or shoulder to check for other injuries, and check for a pulse to make sure blood is circulating normally in your arm. X-ray diagnostics will help to detect the site of a fracture or a fracture in the bone. Sometimes you need to do a CT scan for a more detailed examination of the damaged area.

Treatment

Most elbow fractures are immobilized with a bandage or cast and heal on their own. In case of serious injuries, reposition and fixation of the bone will need to be performed surgically. Sometimes a broken bone breaks through the skin; in this case, the wound will be sewn up and antibiotics will be prescribed to prevent the development of infection. To reduce pain and numbness, the doctor will prescribe painkillers, and applying ice to the injured area will reduce swelling. Poor arm mobility is a common problem during this injury, so your doctor will recommend warm-up and stretching exercises in your arm as soon as your elbow bones are restored.

Self-medication

Injury to the elbow is a medical emergency. Don’t try to straighten your elbow or set a broken bone on your own.