Fracture

What is it?

There are three main types of elbow fracture:

Radial head and neck, when pain is usually worst when  turning the palm up and down. Olecranon, which are at the bottom of the elbow and  usually displace so require surgery. And fractures of the distal humerus, which are common in children and the elderly.

Why does it occur?

These can occur as a result of a fall, a direct impact, or a twisting injury to the arm. Sprains, strains or dislocations can sometimes occur at the same time as a fracture.

What are the symptoms?

Signs of a possible fracture can include pain, swelling, bruising and stiffness in and around the elbow. A snap or a pop at the time of any injury is sometimes also experienced by those with elbow fractures. A clearly visible deformity might mean that the bones are out of place, or that the elbow joint is dislocated, and you could also experience numbness or weakness in the arm, wrist and hand.

How is it diagnosed?

To diagnose a fracture, your consultant will carefully examine your elbow and discuss any recent injury you might have had. They will order advanced imaging tests, such as x-rays, to see where the fracture has occurred and how severe it is.

How is it treated?

Non-surgical
Using a sling, cast or splint are often used when there is a low risk of the bones moving out of place, or when the position of the bones means they will heal naturally. Age can be an important factor, and casts are often used for children as they are at a lower risk of developing elbow stiffness. Rehabilitation will variably include exercises, scar massage, ultrasound, heat, ice and the wearing of splints.

Surgical
Fractures in which the bones have moved out of place or are unstable are more likely to require surgery. In surgery bone fragments would be replaced, stabilised or removed. If the fracture is open (the skin is broken around the fracture), surgery would be  needed urgently, to clean out the wound and bone and reduce the risk of infection. Rehabilitation will variably include exercises, scar massage, ultrasound, heat, ice and the wearing of splints.

Treatment options

The One Orthopaedics team specialists

Anthony Hearnden

Consultant Orthopaedic Specialist FRCS (Tr & Orth)