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The elbow joint is the meeting of three bones and numerous supportive structures, such as muscles and ligaments. At the end of one of these three bones, the ulna, is the olecranon, which forms the pointy tip of the elbow.This elbow bone is not afforded much protection by muscles or other soft tissue structures, making it extremely vulnerable to fractures when fallen upon or subjected to a direct force, as can occur in an accident.
Read on to learn more about the elbow, elbow fractures, their causes, symptoms, diagnosis, and treatment.
Anatomy of The Elbow
The elbow serves two important functions: (1) enabling the arm to bend and straighten and; (2), allowing rotation of the forearm, which consequently allows us to rotate our hands and turn our palms up or down.
The elbow joint is made of three bones and is held together by muscles, ligaments, tendons, and the bones themselves, due to how they are shaped.
The three bones of the elbow include:
The humerous extends from the shoulder to the elbow. The distal humerous forms the center of the elbow joint.
The radius is a forearm bone extending on the thumb side (lateral) of the arm from the elbow to the wrist. The radial head moves around the distal humerous at the elbow joint.
The Ulna and Olecranon
The ulna runs next to the radius in the forearm on the pinky finger side (medial). The olecranon is the tip of the ulna that cups and rotates around the end of the humerous.
Elbow (Olecranon) Fractures
The elbow joint can fracture or otherwise sustain injury in a number of ways. Olecranon injuries are common; and, although they usually occur in isolation, it is possible that elbow fractures can form part of a more complex elbow injury, involving the surrounding bones, muscles, and/or connective tissues.
Common Causes of Elbow Fractures
The most common causes of elbow fracture include:
A fall during which a person lands on an outstretched elbow-locked arm can cause in indirect fracture.
In a fall during which a person lands directly on the elbow or in an accident when the elbow forcefully contacts a hard object, an elbow fracture can occur.
Symptoms Of An Elbow Fracture
When the elbow fractures or any damage is caused to the connective and supportive tissues, the elbow will fail to function normally. Furthermore, symptoms of an elbow fracture can include:
- Feelings of instability, as if the elbow is going to “pop out”
- Sudden and strong pain, often worse with movement
- Inability to straighten the elbow
- Swelling or bruising
- Tenderness at the joint
- Numbness in the fingers
Diagnosing an Elbow Fracture
Because an elbow fracture causes intense pain and immobility of the arm, patients will often seek emergency medical treatment. During an exam the doctor will examine the skin for lacerations (which could indicate a chipped or jagged bone), palpate and check the entire arm and hand to determine if other fractures, dislocations, or related injuries have been sustained, and check the pulse to ensure that adequate blood flow is reaching the wrist and hand. The doctor may also manipulate the arm to check for mobility restrictions and examine the fingers and hands. X-rays are often taken to determine the precise nature and extent of the injuries.
Treatment Process for Elbow Fractures
Initial treatment of an elbow fracture often involves applying ice to reduce swelling, pain medication to reduce discomfort, and a splint or sling to immobilize the joint.
Both non-surgical and surgical methods can be used to treat elbow fractures.
In some cases, just the sling and/or splint will hold the elbow in place to allow sufficient healing to occur. In this scenario, a doctor will closely monitor the rate of healing via x-ray to determine that none of the bone fragments have moved and that healing is, indeed, occurring. Eventually, the patient will begin a recommended exercise program to further facilitate healing. Physical therapy may be required.
While this is can be effective in treating elbow fracture, surgery is sometimes required to facilitate healing. Surgery may be necessary in the following circumstances:
If any of the pieces of the fractured bone are out of place, surgery may be required to put them back so that the bone can heal properly and allow for normal movement and extension of the elbow.
When pieces of the fracture have cut the skin, the risk of infection is higher. For this reason, intravenous antibiotics should be administered very early in treatment. Moreover, surgery is often performed to thoroughly clean the cuts and fix the bones.
Surgery can be performed under a local or a general (going to sleep) anesthesia. During the procedure, the orthopedic surgeon will may an incision at the back of the elbow and manipulate the piece of bone back together. To re-join the fragmented bones, pins, wires, screws, a tension band or sutures may be required. Bone filler may also be used to treat parts of the bone that were crushed during the accident.
It is important to remember that, as with all surgeries, elbow fracture surgery is not without risks, which should be discussed with your doctor. Furthermore, there is a small chance that surgery will not completely and permanently fix the fracture, especially when the patient does not follow post-surgical directions, has other complicating health factors, or the patient had an open fracture. If healing doesn’t proceed as intended following a surgery, additional surgeries may be necessary.
Rehabilitation For Elbow Fractures
With all elbow fractures the goal of treatment and rehabilitation is to return to full pain-free movement of the elbow. While many patients return to normal function after 4 months, many times the healing process can take at least a year. Furthermore, patients should understand that even after months of healing, full range of elbow motion might not be achieved. It is a slow process that often requires physical therapy, special braces, and maybe even additional surgery.
Unfortunately, one of the common complications of elbow fracture is developing arthritis in the joint, which causes it to become stiff and painful. Elbow arthritis can develop quickly or take years.