Elbow Trauma

Three bones—humerus, radius, and ulna—make up the elbow joint. The bones are held together by ligaments thus providing stability to the joint. Muscles and tendons around the bones coordinate the movements and help in performing various activities. Elbow fractures may occur from trauma resulting from a variety of reasons, some of them being a fall on an outstretched arm, a direct blow to the elbow, or an abnormal twist to the joint beyond its functional limit.

The types of elbow fractures include:

• Radial head and neck fractures: Fractures in the head portion of the radius bone are referred to as radial head and neck fractures. In these fractures pain gets worsened with the movement of the forearm. Fractures that are not displaced do not require surgery and are treated by early motion. However, surgery is indicated if it is a displaced fracture to repair and align the fragments. In severe cases the radial head is either removed or replaced.
• Olecranon fractures:These are fractures occurring at bony prominence of the ulna. The fractures, if stable, are treated using an immobilizing splint followed by a regimen of motion exercises. However severe fractures require surgical repair.
• Distal humerus fractures: These fractures are common in children and elderly people. Nerves and arteries in the joint may sometimes be injured in these fractures. Surgery is usually required for displaced fractures and fractures compounded by nerve and/or artery injuries.

Symptoms of an elbow fracture include pain, swelling, bruising, stiffness in and around the elbow, a popping or cracking sound, and deformity of the elbow bones.

To diagnose elbow fractures X-rays of the joint are taken. In some cases, a CT scan may be needed to get to know the details of the joint surface.

The aim of the treatment is to maximize early motion to reduce the risk of stiffness. Nonsurgical treatment options include use of a splint or a sling to immobilize the elbow during the healing process. Surgery is indicated in displaced and open fractures to realign the bones and stabilize the joint as well as to avoid deep infections. Strengthening exercises, scar massage, therapy with ultrasound, heat, and ice are recommended to improve the range of motion. Splints are also used to facilitate stretching of the joint.