The elbow is a complex and important joint for function of the upper limb. The upper part of the elbow joint is the humerus (the bone between your shoulder and elbow). The lower part of the joint is made up of the two forearm bones; the ulna and the radius. The elbow can be considered to have two planes of movement; flexion and extension (bending and straightening) and pronation and supination (forearm rotation, palm-down to palm-up). Good elbow movement and stability is essential for reaching, pulling, pushing and lifting as well as many sport-related activities.
Definition
Elbow fractures can include fractures of any or all of the three bones of the elbow. Often, this type of fracture occurs in conjunction with injuries to ligaments of the elbow.
Radial Head Fractures: These are fractures of the top end of your radius, which is bone on the thumb side of your forearm. The radial head is mostly involved in forearm rotation and this movement may be the most painful or restricted in this type of fracture.
Olecrannon Fractures: This is the most common part of the ulna to fracture. It is the part of the bone that can be felt at the point of your elbow and the back of your upper forearm.
Condylar or Supra-condylar fractures: These are fractures of the distal humerus, meaning the lower end of the humerus. They are most common in children or the elderly but can also occur in high impact injuries.
Causes
Elbow fractures are most often caused by higher impact injuries such as a fall from heights or at speed and also car accidents. Falling directly on the elbow or a direct blow to the elbow may break the olecrannon but a fall on an outstretched hand can also transmit forces up the arm to injure the elbow too. These fractures are sometimes associated with dislocations.
Signs & Symptoms
Elbow fractures usually come with sudden and significant pain in the elbow. You will also usually have significant swelling, however this can sometimes be delayed.
You will probably be unable to move your elbow through its full range of motion including having difficulty bending or straightening it, or rotating your forearm but this may vary depending on your fracture type. You will usually still be able to move your fingers and your thumb.
If you feel any numbness or tingling below the elbow this is a sign that some of the nerves or blood vessels that run close to your elbow may be affected and it is essential that you go to an Emergency Department as soon as possible or call an ambulance if required.
If the elbow is obviously out of place or if there is any visible bone penetrating the skin it is also essential that you seek emergency medical assistance as soon as possible.
Treatment
Treatment of elbow fractures can vary significantly depending on which bone breaks, whether it is displaced or non-displaced (that is whether it has moved or remained in-place) and the pattern of the fracture.
Some elbow fractures will need surgical procedures so that the bone fragments can be put in place and others will need plates, screws or wires to help stabilise them. The decision on whether an operation is needed is best made by an Orthopaedic Surgeon. To help in this decision making process you may need an X-ray or CT Scan. Other imaging may be requested to assess the ligaments and tendons such as an MRI or ultrasound.
Some fractures can be appropriately managed with nonsurgical treatment . This will often require a sling or with splinting or casting to hold the elbow in a safe position. Hand and upper limb therapists are able to fabricate the appropriate immobilisation for you.
Following surgery or immobilisation most people require rehabilitation to get the elbow, wrist and hand moving again and to help with strengthening in order to return to activities of daily living, work or sport. It is essential that movement of the elbow is started as soon as it is safe in order to prevent long term stiffness. Following surgery, scar care and swelling management are important aspects of rehabilitation.
Prevention Of Elbow Fractures
Elbow fractures are usually the result of an accident and so the only way to prevent them is to assess and manage risks in your life. This can be done with the following:
- For sportspeople, maintaining the fitness, mobility, strength and power required for your sport can help minimise all types of injuries, as can ensuring that you play safely and follow safety rules.
- Wearing protective gear for extreme sports can help to manage the risks associated but it is equally important that you play within your ability.
- As we get older people can have an increased risk of falling. Falls Prevention Clinics are run by multidisciplinary teams of physios, occupational therapists, nurses and doctors and can help by assessing risk, making recommendations, changing medications, eyewear and footwear and prescribing exercise to keep strong and maintain balance.
- When driving, ensure that you drive according to the conditions and stick to the speed limit
Melbourne Hand Therapy Can Help You
Our experienced occupational therapists and physiotherapists are skilled at rehabilitating elbow fractures to get you the best possible result and help you get back to doing what you love. We also work with the best upper limb surgeons in Melbourne and these connections will ensure that you get the right treatment as soon as possible. So if you’ve experienced an elbow injury book an initial assessment TODAY!
