Your elbow is a hinged joint made up of 3 bones: your upper arm bone (humerus) and the two bones in your forearm (ulna and radius). Muscles, ligaments, and tendons hold the elbow joint together, to form the joint capsule- a fluid filled sac that surrounds and lubricates the joint.
The muscles in your forearm cross the elbow and attach to the humerus. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle, while the bump on the inside of your arm is called the medial epicondyle.
The important ligaments of the elbow consist of the medial collateral ligament (on the inside of the elbow) and the lateral collateral ligament (on the outside of the elbow). These ligaments work together to stabilise the elbow, holding the humerus, radius and ulna tightly together. Another ligament called the annular ligament holds the radial head tightly against the ulna.
The tendons in your elbow attach muscle to bone. The biceps tendon attaches the biceps muscle on the front of your arm, and the triceps tendon attaches the triceps muscle to the back of your arm.
The arm consists of nerves that travel down and move across the elbow. There are three main nerves: the radial nerve, the ulnar nerve and the medial nerve. These nerves are responsible for controlling your muscles and sensations, such as touch, pain and temperature.
WHAT IS AN ELBOW FRACTURE?
An elbow fracture is a break in the tip of your elbow. The elbow joint is made up of 3 bones- humerus, ulna and radius. If a fracture occurs in any of the 3 bones, it can be very painful and make elbow motion difficult or impossible.
There are 3 types of elbow fractures:
- Olecranon fracture
The most common type of elbow fracture, an olecranon fracture is a break in the bony “tip” of the elbow. The olecranon is located at the end of the ulna and directly under the skin of the elbow, which is thin and does not have much protection from muscles or other soft tissues. This makes it very vulnerable to fracture.
- Radial head fracture
The radial head is the end of the radius that connects with the humerus at the elbow joint. Radial head fractures occur when there is an impact that causes the radial head to push into the humerus so hard that it causes a fracture, such as when someone breaks a fall with their arm.
- Distal humerus fracture
The distal humerus is the lower end of the humerus that forms the upper part of the elbow. Distal humerus fractures occur when there is a direct blow or huge impact to the elbow.
WHAT ARE THE SYMPTOMS OF AN ELBOW FRACTURE?
Some symptoms of an elbow fracture include:
- Severe and intense pain in the elbow when moving or rotating the forearm
- Inability to move the elbow
- Swelling at the end or back of the elbow
- Bruising and discolouration in the elbow
- Finger numbness
- Tenderness to the touch
- Feeling of instability in the joint
WHAT ARE THE CAUSES AND RISK FACTORS OF AN ELBOW FRACTURE?
Elbow fractures have a number of causes, such as:
- Direct fall onto the elbow.
- High impact or direct blow to the elbow due to a motor vehicle accident or from being hit by something hard
- Breaking a fall and falling on an outstretched arm.
WHAT IS THE DIAGNOSIS OF AN ELBOW FRACTURE?
A history of the injury and a physical examination of the elbow and arm will be conducted by the Doctor. He will do some physical tests, such as checking if there are any other areas of tenderness, checking on your pulse and blood flow, and if you are able to move your fingers and wrist.
Imaging tests will be taken, such as an x-ray to confirm the type and severity of elbow fracture. A CT scan may also be taken if required.
WHAT ARE THE TREATMENT OPTIONS FOR AN ELBOW FRACTURE?
If your bones are not displaced (out of alignment), nonsurgical treatment methods will be used, such as:
- Placing your elbow in a splint or sling to hold the elbow in place
- Physiotherapy, such as gentle exercises to help you regain muscle strength and restore your range of motion
Should your fracture be displaced or if the bones are exposed through the skin, surgery is recommended.
The most common surgical procedure performed is open reduction and internal fixation. This procedure involves the repositioning (reduction) of the bone pieces into their regular alignment. These pieces are then held in place by screws, wires, pins or plates made of metal which are attached on the outside of the bone.
WHAT IS THE RECOVERY PROCESS AFTER AN ELBOW FRACTURE SURGERY?
Depending on the extent of the injury, recovery time varies from case to case. Do expect to be in a splint or cast for a period after your surgery to help support the recovery. Physiotherapy will also be required, to help improve your range of motion and regain your muscle strength. Refrain from lifting heavy objects, and doing activities that will strain your elbow.
WHAT ARE THE RISKS AND COMPLICATIONS OF AN ELBOW FRACTURE SURGERY?
Even though the surgery is very safe, however there may be some complications. These include:
- Damage to surrounding nerves and blood vessels
- Non-union of the bones
- Irritation from the implants