An elbow fracture is a break in one or more of the bones that make up the elbow: the humerus, the ulna and the radius.
Common types of fracture include distal humerus (intercondylar), affecting the lower end of the humerus; radial head, affecting the radius near the elbow; and olecranon, affecting the bony tip of the ulna.
Elbow fractures are typically accompanied acute pain at the time of injury, followed by swelling and a significant reduction in range of motion at the joint and in forearm roatation.
The injured arm may appear shorter in comparison with the uninjured arm, and may be pronated (palm down) and fixed. Any movement may be accompanied by a grating or cracking sound, and one or more of the fingers may feel numb.
Elbow fractures, like other bone fractures, are typically the result of high energy trauma, such as a fall from height, car accident or a direct blow during sports. Less commonly, they can be the result of repetitive strain or continuous use, particularly in the presence of underlying bone weakness.
Non-surgical treatment options are typically only considered for minor fractures where the joint has remained stable. These include:
Immobilisation: a cast or splint is used to stabilise the elbow in place and allow normal healing. Where the fracture has already begun to heal, a sling may be used.
Pain management: icing and non-steroidal anti-inflammatory medications can be used to reduce pain and inflammation associated with the fracture.
Surgical treatment is typically neccessary where the fracture is severe or displaced, or where the bone is fragmented into more than two parts. These include:
Open reduction and internal fixation: involves directly realigning the bone fragments and then securing them in place udring plates, screws or pins to allow for normal healing. Where bone fragments are missing or severely damaged, bone filler may be used.
External fixation: where the soft tissue around the elbow is too damaged to allow for internal fixation, external fixation using an external frame, can be used to stabilise the bone during healing.
Radial head replacement: where the radial head is unsalvagable, it may be removed and replaced with a prosthetic implant.
Elbow replacement: where serious damage is more extensive, or for patients with poor bone quality, damaged parts of the elbow may be replaced with prosthetic components.
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