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Elbow Fracture
Elbow Intercondylar Fracture Information
The elbow is a hinge joint composed of three bones:
- The Ulna: One of the forearm bones between the elbow and wrist. When palm is facing up the ulna is on the pinky side (medial side) of the forearm
- The Radius: The other forearm bone between the elbow and wrist. When the palm is facing up, the radius is on the thumb side (lateral side) of the forearm
- The Humerus: The upper arm bone between the shoulder and the elbow
The humerus and the paired radius and ulna meet to form the elbow joint. The olecranon is the bony prominence of the elbow. It is positioned directly under the skin of the elbow without much protection from muscles or other soft tissues.
For this reason, injuries and fractures of the elbow are common and are often accompanied by injury to the shoulder or wrist joints. The joint can easily fracture if you experience a direct blow to the elbow or fall on a bent elbow.
Intercondylar fractures are T or Y shaped fractures with varying displacement between the condyles and the humerus.
They are the result of a direct (falling directly onto the elbow) or indirect blow (landing on the wrist with the arm locked out straight) to the elbow where the olecranon (the bony point of the elbow) is forced as a wedge between the two condyles of the humerus.
Elbow Intercondylar Fracture Signs and Symptoms
- Sudden intense pain
- Swelling of the elbow and surrounding tissue
- Limited range of motion, particularly forearm rotation and elbow extension and pain increasing while doing these movements
- Often the arm will be held in pronation (palm facing down) unable to be moved
- Inability to straighten elbow
- Tender to touch
- The injured forearm may appear shortened
- Grating, cracking or popping feeling in arm when the condyles are pressed together
- Numbness in one or more fingers
Treatment
An elbow intercondylar fracture is confirmed with x-rays to assess the severity of the injury and any associated injuries.
Surgery is recommended as the best course of action following an elbow fracture, especially if there is evidence of nerve or vascular involvement.
Complex fractures require open reduction and internal fixation.
During the procedure an incision is made over the back of the elbow and the bone fragments are first reduced (repositioned) into their normal alignment. The bones are then positioned and held together by a plate attached to the outer bone using pins and screws. In some cases a screw or rod inserted into the bone may be used to keep the bone fragments together while they heal.
If some of the bone is missing or crushed beyond repair (fragments of bone broken off in an accident for example) the fracture may require a bone filler. This can be supplied by the patient (typically taken from the pelvis) or fragment of bone from a bone bank or using an artificial calcium-containing material.
After the incision is closed, a splint may be placed on the arm depending on the severity of the injury.
Most patients will return to full range of motion in the elbow following surgery and can be expected to return to normal activities within four to six months. However, full healing and return to sports may take longer.
Elbow Fractures in Children
Elbow fractures can be difficult to diagnose in children as the radial head (the head of the forearm bone) ossification does not occur until age four. These fractures may be associated with an ulna shaft fracture as well and often an ultrasound or MRI may be needed to confirm the diagnosis.
For more information on elbow fractures in children see Paediatric Elbow Trauma Repair.
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