What are the causes of olecranon fractures. How are elbow fractures diagnosed. What treatment options are available for chipped bones in the elbow. How long does recovery from an olecranon fracture take. What complications can arise from elbow fractures.

Understanding Olecranon Fractures: Anatomy and Mechanisms of Injury

Olecranon fractures are breaks in the bony tip of the elbow, a part of the ulna that plays a crucial role in elbow function. These fractures can range from minor cracks to complex, displaced breaks involving multiple bone fragments. To fully grasp the implications of such injuries, it’s essential to understand the anatomy of the elbow joint.

The Elbow Joint: A Complex Structure

The elbow is a joint formed by three bones:

• Humerus (upper arm bone)
• Radius (forearm bone on the thumb side)
• Ulna (forearm bone on the pinky side)

The olecranon is the prominent part of the ulna that forms the point of the elbow. It’s covered by a thin layer of tissue, making it vulnerable to injury. The elbow’s ability to bend, straighten, and rotate depends on the intricate interplay of these bones, along with supporting ligaments, tendons, and muscles.

Common Causes of Olecranon Fractures

Olecranon fractures typically occur due to:

• Direct falls onto the elbow
• Blows from hard objects (e.g., baseball bats or car parts during accidents)
• Falls on an outstretched arm with a tightly held elbow

In some cases, the triceps muscle can pull a piece of bone off the ulna during a fall. These injuries may also involve damage to surrounding ligaments.

Recognizing the Signs and Symptoms of an Olecranon Fracture

Identifying an olecranon fracture promptly is crucial for proper treatment. The symptoms often include:

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

Is immediate medical attention necessary for suspected olecranon fractures? Yes, seeking prompt medical evaluation is crucial, especially if there’s severe pain, visible deformity, or an open wound near the elbow.

Diagnostic Procedures for Elbow Fractures

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

Physical Examination

The initial assessment includes:

• Visual inspection for cuts, swelling, blistering, and bruising
• Palpation to identify areas of tenderness and potential additional injuries
• Pulse check at the wrist to ensure proper blood flow
• Evaluation of finger and wrist movement and sensation

Imaging Studies

While the physical examination provides valuable information, imaging studies are essential for a definitive diagnosis:

• X-rays: The primary imaging tool for diagnosing olecranon fractures
• CT scans: May be used for more complex fractures to provide detailed 3D images
• MRI: Occasionally used to assess soft tissue damage around the elbow

How do these imaging studies help in treatment planning? They allow doctors to determine the fracture’s severity, displacement, and whether surgery might be necessary.

Treatment Options for Olecranon Fractures

The treatment approach for olecranon fractures depends on the severity of the injury, the patient’s overall health, and their activity level. Options include:

Non-Surgical Treatment

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

• Immobilization with a splint or cast
• Pain management with over-the-counter or prescription medications
• Gradual range-of-motion exercises as healing progresses

Surgical Intervention

Most olecranon fractures require surgery to restore normal elbow anatomy and function. Surgical techniques may include:

• Open reduction and internal fixation (ORIF) with plates and screws
• Tension band wiring for certain fracture patterns
• Fragment excision and triceps advancement for comminuted fractures in older patients

What factors influence the choice between surgical and non-surgical treatment? The decision depends on fracture displacement, joint stability, patient age, and activity level.

Rehabilitation and Recovery After Olecranon Fracture Treatment

Recovery from an olecranon fracture is a gradual process that requires patience and dedication. The rehabilitation timeline varies depending on the severity of the injury and the chosen treatment method.

Early Recovery Phase

In the initial weeks after injury or surgery:

• Immobilization to protect the healing bone
• Pain management and swelling control
• Gentle range-of-motion exercises as advised by healthcare providers

Progressive Rehabilitation

As healing progresses:

• Gradual increase in elbow motion and strength exercises
• Physical therapy to improve flexibility and function
• Occupational therapy for fine motor skills and daily activities

How long does full recovery typically take? While initial healing occurs within 6-12 weeks, complete recovery and return to full activities may take several months.

Potential Complications and Long-Term Outlook

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

• Infection (especially in open fractures)
• Nonunion or malunion of the fracture
• Stiffness or limited range of motion
• Hardware irritation requiring removal
• Post-traumatic arthritis

Can these complications be prevented or minimized? Many complications can be reduced through proper initial treatment, careful follow-up, and adherence to rehabilitation protocols.

Prevention Strategies and Lifestyle Modifications

While not all olecranon fractures can be prevented, certain measures can reduce the risk:

• Wearing protective gear during sports and high-risk activities
• Maintaining bone health through proper nutrition and exercise
• Creating a safe home environment to prevent falls
• Using proper form and technique during physical activities

How can individuals at higher risk of fractures (e.g., those with osteoporosis) protect their elbows? They should focus on fall prevention, consider balance training, and discuss bone-strengthening medications with their healthcare providers.

Advancements in Olecranon Fracture Treatment and Research

The field of orthopedics continues to evolve, bringing new hope for improved outcomes in olecranon fracture treatment:

Innovative Surgical Techniques

• Minimally invasive approaches for certain fracture types
• Advanced fixation devices designed for better stability and faster healing
• Computer-assisted surgery for more precise implant placement

Biological Therapies

Emerging treatments to enhance bone healing include:

• Platelet-rich plasma (PRP) injections
• Bone morphogenetic proteins (BMPs)
• Stem cell therapies

What impact might these advancements have on recovery times and long-term outcomes? While promising, many of these techniques are still under investigation and may not be widely available or suitable for all patients.

Living with an Olecranon Fracture: Patient Experiences and Support

Coping with an olecranon fracture can be challenging, both physically and emotionally. Patients often benefit from:

• Support groups or online forums for sharing experiences
• Occupational therapy to adapt daily activities during recovery
• Psychological support to manage frustration or anxiety during the healing process

How can family members and caregivers best support someone recovering from an olecranon fracture? Providing practical assistance, emotional support, and encouragement to follow medical advice can significantly impact the recovery journey.

When to Seek Medical Attention for Elbow Pain or Injury

Not all elbow pain indicates a fracture, but certain symptoms warrant immediate medical evaluation:

• Visible deformity of the elbow
• Intense pain that doesn’t improve with rest and ice
• Inability to move the elbow
• Numbness or tingling in the hand or fingers
• Signs of infection, such as fever or redness spreading from the elbow

Should minor elbow injuries always be evaluated by a healthcare professional? While not all minor injuries require immediate attention, persistent pain or functional impairment should be assessed to rule out subtle fractures or other significant injuries.

Olecranon Fractures in Special Populations

The approach to olecranon fractures may vary for certain groups:

Pediatric Olecranon Fractures

Children’s bones heal differently and may require specialized care:

• Greater potential for remodeling, allowing for more conservative treatment in some cases
• Consideration of growth plate involvement and its long-term implications
• Tailored rehabilitation to ensure proper development and function

Geriatric Olecranon Fractures

Older adults face unique challenges:

• Increased risk of complications due to osteoporosis or other medical conditions
• Potential need for modified surgical techniques or implants
• Focus on maintaining independence and preventing future falls

How do treatment goals differ between younger and older patients with olecranon fractures? While younger patients often aim for complete restoration of function, treatment for older adults may prioritize pain relief and maintenance of essential daily activities.

The Role of Physical Therapy in Olecranon Fracture Recovery

Physical therapy is a crucial component of rehabilitation after an olecranon fracture:

Early Phase Therapy

• Pain management techniques
• Gentle range-of-motion exercises
• Edema control strategies

Progressive Rehabilitation

• Strengthening exercises for the arm and shoulder
• Functional training to restore daily activities
• Proprioception and coordination exercises

How long should physical therapy continue after an olecranon fracture? The duration varies but often extends several months beyond the initial healing period to ensure optimal functional recovery.

Nutritional Considerations for Optimal Fracture Healing

Proper nutrition plays a vital role in bone healing and recovery:

• Adequate protein intake to support tissue repair
• Calcium and vitamin D for bone strength
• Vitamin C and zinc to promote collagen formation
• Omega-3 fatty acids for their anti-inflammatory properties

Can dietary changes significantly impact fracture healing time? While good nutrition supports the healing process, it’s just one factor among many that influence recovery speed.

The Impact of Olecranon Fractures on Daily Life and Work

Recovering from an olecranon fracture can significantly affect a person’s daily routine and work life:

Challenges in Daily Activities

• Difficulty with personal hygiene tasks
• Limitations in dressing and grooming
• Challenges with cooking and household chores

Work-Related Considerations

• Potential need for temporary work modifications or leave
• Gradual return-to-work plans for physically demanding jobs
• Adaptations for computer use or fine motor tasks

How can employers support employees recovering from olecranon fractures? Flexible work arrangements, ergonomic adjustments, and phased return-to-work programs can facilitate a smoother transition back to full duties.

Future Directions in Olecranon Fracture Management

The field of orthopedics continues to evolve, promising improvements in olecranon fracture care:

Emerging Technologies

• 3D-printed custom implants for complex fractures
• Virtual reality applications for rehabilitation
• Wearable sensors for monitoring healing and function

Research Frontiers

• Gene therapy approaches to enhance bone healing
• Nanotechnology for targeted drug delivery to fracture sites
• Artificial intelligence for predicting outcomes and personalizing treatment plans

How might these advancements change the landscape of olecranon fracture treatment in the coming years? While many of these technologies are still in development, they hold the potential to significantly improve treatment precision, recovery times, and long-term outcomes for patients with olecranon fractures.

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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Elbow Fractures: Symptoms & Treatment

Elbow fractures may result from a fall, a direct impact to the elbow, or a twisting injury to the arm. Sprains, strains, or dislocations may occur at the same time as a fracture.

Figure 1

The elbow joint

Figure 2

Radial neck elbow fracture

Figure 3

Olecranon elbow fracture and repair

Figure 4

Displaced supracondylar humerus elbow fracture in a child

Causes

There are three main bones in the elbow (see Figure 1): the humerus, the radius, and the ulna. The radius spans the length of the forearm from the wrist to the elbow, and the head and neck of the radius bone are inside the elbow joint. The ulna also spans from the elbow to the wrist, but the head is in the wrist, and the cup-shaped part in the elbow is called the olecranon. The humerus starts at the shoulder, and the end (distal) part of it is in the elbow. The location of the fractured bone is important to identify as this will determine the proper treatment and rehabilitation. In some severe cases, multiple bones may be broken at the same time. The main types of fractures are included below.

Radial head and neck fractures (see Figure 2)

The radial head and neck, which are closest to the elbow, are important for rotation of the forearm (twisting from palm up to palm down). The pain associated with these fractures is present on the outside (lateral) portion of the elbow and usually worse with forearm rotation.

The treatment for this fracture depends on the number and size of the bone fragments. Simple fractures can be treated with a brief period of immobilization with a splint or sling followed by moving the elbow to pain tolerance. Complex fractures often require surgery with screws or a plate. Some more complicated fractures may require replacing the radial head with a metal implant if there are too many bony pieces. Complex fractures may also involve ligament injuries that need to be surgically repaired.

Distal humerus fractures (see Figure 3)

These fractures involve the portion of the humerus closest to the elbow joint. This bone contains the entire joint surface of the elbow. Distal humerus fractures often involve the joint and will require surgery, which involves repairing the fracture with plates and screws. These injuries are very complex and typically require multiple plates to stabilize the broken bones.

Special considerations should be made for fractures in children and the elderly. The growing areas of the elbow bones (growth plates) in a child are softer and can break with minor falls on a playground or off a trampoline. In children, many fractures can be treated with a cast, but some more severe fractures may need surgery, which involves repairing the fracture with temporary wires followed by casting. In elderly patients, the bone at the distal humerus may be brittle. In these cases, plate and screw surgery may not be an option, and a total elbow replacement with a metal implant may be more appropriate.

Olecranon fractures (see Figure 4)

The olecranon is the portion of the ulna bone closest to the elbow. Fractures that occur around the olecranon usually are displaced due to the pull of the triceps tendon, which attaches to the tip of this bone. Most of these fractures also involve the joint surface. For these reasons, these fractures typically require surgery. The bone fragments are re-aligned and held together with pins and wires or plates and screws.

More complex olecranon injuries can result in dislocation, which is when all the ligaments around the elbow joint tear, separating the bones from their hinge.

Dislocations can also happen along with an olecranon and radial head fracture (triple triad). These typically require surgery to put the hinge joint back in place and address all broken bones and injured ligaments.

Signs and Symptoms

Elbow fractures are associated with pain, swelling, and loss of motion. A snap or pop at the time of injury may be felt or heard. Visible deformity and decreased ability to move the elbow fully might mean that the bones are out of place or that the elbow joint is dislocated, and x-rays are used initially to confirm the injuries. Sometimes a CT (Computed Tomography) or an MRI (Magnetic Resonance Imaging) scan might be needed to get further detail.

Nerve and/or artery injuries at the time of elbow fracture are rare and result in numbness or discoloration of the arm, wrist, and hand. These injuries are temporary, but those symptoms must be urgently and carefully evaluated by a medical professional.

Treatment

Initial treatment for these fractures involves careful evaluation by a medical professional; placement of a splint, brace, or sling; and rest. Medication may be prescribed to reduce pain and swelling.

Fractures that are out of place or unstable are more likely to require surgery. Whenever a fracture is open (skin broken over the fracture), urgent surgery is needed to clean out the wound and bone to minimize the risk of infection.

When the bones are at a low risk of moving out of place or are in a stable condition, treatment calls for non-surgical measures such as a removable sling, brace, or an immobilizing castor. The elbow is unique in that moving or exercising simple, non-displaced fractures early, even while the bones are still healing, is safe and helpful to prevent stiffness.

Age is also an important factor when treating elbow fractures. Casts are used more frequently in children, even in simple fractures, as they protect the joints while they heal as children might not understand the risks of certain activities. A child’s risk of developing elbow stiffness is lower; however, in an adult, elbow stiffness is much more likely.

Rehabilitation directed by your medical professional is often used to maximize motion and decrease the chance of getting elbow stiffness. This might include working with a hand therapist using exercises, scar massages, ultrasounds, heat, ice, and splints that stretch the joint.

© 2022 American Society for Surgery of the Hand

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.

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

29.03.2016

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-treatment

Injury to the elbow is a medical emergency. Don’t try to straighten your elbow or set a broken bone on your own. To reduce pain and swelling, apply ice to the injured area while you wait for medical attention.

When to see a doctor

Call your doctor or emergency room if you suspect you have a broken elbow.

Risk factors

Risk factor – participation in activities that can lead to a fall or a direct blow to the elbow.

Displacement of wires for fractures – removal of protruding metal structures

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Metal structures for fractures are used in cases of displacement or crushing of bones. Reliable fixation of bones with the help of metal spokes, plates and other elements is the key to their proper fusion.

But what if the pin came out of the clavicle? Should you sound the alarm and run immediately to the hospital, or is this normal and there is no cause for concern? Similar questions often arise in patients who have seen that the pin has shifted, or have begun to feel some discomfort.

There is no need to panic in such situations, although ignoring the problem is not the best option. In this case, a doctor’s consultation is required. The traumatologist will answer all questions and tell you whether it is necessary to remove the plate after the fracture. Usually, the metal structure is removed after a while, but there are exceptions.

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Can the spokes move?

Metal structures are often used for fractures. Their main purpose is reliable fixation of bones, which ensures their proper fusion and prevents possible complications.

Patients often wonder if the pins can move. The question is usually related to the fact that a person sees how the structure changes its position relative to the original location. Indeed, sometimes it happens that a spoke or other elements of a metal structure migrate.

This happens for the following reasons:

• mechanical impact;
• structure incorrectly installed;
• not firmly fixed;
• poor quality materials used;
• physiological changes have occurred in the body, etc.

If a displacement has occurred, in most cases the removal of the hardware is required. However, the decision to perform the operation should be made by the doctor after a preliminary examination of the patient and additional diagnostics.

What should I do if the needle comes out of my hand?

Most patients do not know what to do if a pin comes out of their hand. Often this phenomenon does not bother a person, although it causes inconvenience.

If the pin is above the skin, proceed as follows:

Treat the puncture site with an antiseptic to prevent infection.

Use wound healing ointment.

Apply a sterile dressing. Repeat the steps 2-3 times a day if it is not possible to immediately consult a doctor.

Make an appointment with a traumatologist for a consultation within the next 2-3 days. After the examination, he will decide whether an emergency removal of the metal structure from the collarbone is required or whether it will be possible to do without intervention.

When is the removal of a metalwork required?

Usually, the removal of a metal structure from the lower leg or arm is performed after 8-12 months, when the bone tissue has completely healed. The decision should be made by the doctor after examining the x-ray and examining the patient.

Removal of hardware may be required urgently in the following cases:

• metal intolerance;
• occurrence of purulent inflammation;
• significant displacement due to poor fixation;
• broken plate or screws;
• risk of re-fracture;
• limited joint mobility;
• physical or psychological discomfort due to the presence of a foreign body in the body, etc.

Premature removal of metal structures from the spine is performed in rare cases, if there are medical indications for this.

How is the operation to remove a metal structure performed?

In most cases, the operation to remove a metal structure is performed as planned. The patient is preliminarily given an X-ray examination and CT scan to assess the condition of the fused bones, to determine the absence or presence of complications. Diagnostic measures help to correctly remove a metal structure from a leg or other part of the body.

Removal of a metal structure from the clavicle or lower limb is performed under general anesthesia in a hospital. The doctor makes an incision along the primary scar. With severe scarring of tissues, the scar can be completely excised, which subsequently allows you to simultaneously solve the aesthetic problem. The doctor dissects soft tissues, after which he removes the plate or pin, removing the clamps.

The operation to remove the hardware is completed as follows:

• The doctor successively stitches soft tissues and subcutaneous tissue.