Elbow Fractures

An elbow fracture is a break in one of the three bones that form the elbow: the lower end of the upper arm bone, the larger forearm bone, or the smaller forearm bone on the thumb side. A break can be a hairline crack with the pieces still in place or fragments that have shifted apart. How far the pieces have moved decides whether surgery is needed. The elbow does not tolerate being held still for long, and stiffness is the most common problem after any elbow injury, so most plans are built around getting motion started as early as the fracture allows.

Common symptoms include:

• An elbow that swelled quickly after a fall or blow and will not fully bend or straighten
• Pain that begins right away, made worse by any movement
• Pain when rotating the forearm, or loss of the ability to straighten the arm against gravity
• Numbness or tingling in the ring and small fingers, which can signal nerve involvement

Diagnosis is based on a physical exam that checks which movements hurt, whether the elbow is stable, and whether the nerves around the elbow are working. X-rays from the front and side identify most fractures, and a CT scan is added when the pattern is complex or surgery is being planned.

Fractures that have not shifted are often treated without surgery:

• A splint or sling for comfort in the first few days, not for weeks
• Early range-of-motion exercises started as soon as comfort allows
• Physical therapy to restore strength and full movement

Surgery is offered when a fracture has shifted enough to block motion or compromise the joint's stability. Depending on the pattern, the fragments are held with screws, a plate, or a wire technique, a shattered bone end may be replaced, and severely fragmented bone in older patients may be treated with elbow replacement.

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Elbow (Olecranon) Fractures — AAOS OrthoInfo