Elbow Fracture – Orthopedic Diagnosis and Treatment of Elbow Fractures

Strictly speaking, an elbow fracture is a fracture of the adjacent bones in the elbow region.

These include fractures such as:

• Olecranon fracture
• Radius fracture
• Radial head fracture or
• ulna fracture

Since such a fracture occurs acutely as a result of trauma (injury), the following symptoms often occur:

• Severe pain
• Bruising and
• Severe swelling in the area of the elbow joint

Elbow fractures affect all age groups @ Mathis /AdobeStock

The elbow joint’s range of motion is also limited. Depending on the severity of the fracture, the doctor may also be able to feel bone fragments. In an open fracture, bone fragments protrude through a wound. If an elbow fracture remains untreated, it usually leads to joint stiffness and permanent limitations in movement.

Elbow fractures most commonly occur when falling onto the arm or when bracing oneself during a fall. If the mechanical stress on the arm is too great, the bone breaks at its weakest point—often in the area of the joints, such as near the elbow joint.

Other possible causes of an elbow fracture include:

• Blunt force trauma to the elbow
• Osteoporosis (“brittle bones”)
• Bone tumors
• Bone metastases from tumors that have spread, or
• Stress fractures following prolonged overuse of the bones

Diagnosis of an elbow fracture

The doctor obtains initial indications based on the following clinical symptoms in the elbow area following a fall:

• Swelling
• Bruising
• Limited mobility
• Severe pain

If these signs are present, an elbow fracture may be suspected.

To confirm the diagnosis, the doctor will take an X-ray. Further tests will determine whether there is damage to muscles, ligaments, and blood vessels.

Since parts of the bones in the elbow region serve as attachment points for the arm muscles, bone fragments may be palpable. Complicated fractures, comminuted fractures, and open fractures are usually characterized by a large number of bone fragments. These are more difficult to heal. As a rule, such fractures require surgical correction and stabilization.

Treatment of an Elbow Fracture

Before seeing a doctor, you should ice the arm and keep it immobilized. This helps prevent further complications and damage to the elbow joint.

After the examination and diagnosis, the elbow fracture specialist will treat the fracture conservatively in most cases. 

The arm is placed in a cast for about six weeks to stabilize it. The cast also helps the bones along the fracture line to heal together.

It is important to note that a cast is used only for uncomplicated elbow fractures. If there are displaced bone fragments or if the fracture is open, surgery is necessary. Screws, wires, or small metal plates are used to further reconstruct and stabilize the bone. This procedure is performed under general anesthesia.

In addition, if a fracture is suspected, care must be taken to ensure that the forearm and hand are consistently protected to prevent further soft tissue injuries while the arm is in a cast. If the elbow has been treated surgically, the duration of sick leave depends on the healing process, the stability of the bones, and the patient’s ability to handle daily activities. Close follow-up care by experienced elbow specialists is crucial for detecting complications early and providing optimal support for the restoration of function.

A cast or surgery are risk factors for elbow stiffness @ photoguns /AdobeStock

The prognosis for an uncomplicated elbow fracture

In most cases, an uncomplicated elbow fracture has a good prognosis for healing. It is one of the most common bone fractures in humans.

Even if minor surgery is necessary, the fracture often heals without complications. The situation is somewhat more challenging if the elbow fracture involves bone fragments. These may lead to long-term complications because the bone no longer heals together properly.

This can lead to adhesions on the bones, which promote abnormal stress on the joint and osteoarthritis. Despite the good prognosis, it is possible that the bones will not be as strong as before once they have healed. High-impact sports such as squash, golf, or tennis may only be possible to a limited extent or may no longer be possible at all.

Since the muscles in the arm atrophy due to the cast, physical therapy is recommended after the cast is removed. This is intended to strengthen the muscles again.

Can an elbow fracture be prevented?

In general, injuries from falls tend to be accidental, so there is no direct prevention strategy for elbow fractures. However, you should wear elbow pads when biking or inline skating to reduce the risk of an elbow fracture.

Where do elbow fracture specialists work?

Specialists in elbow fractures are primarily found in the fields of orthopedics and trauma surgery.

For complicated elbow fractures, centers for orthopedics and trauma surgery with sufficient experience are recommended.

Conclusion

An elbow fracture often affects the forearm and is usually caused by a fall onto an outstretched arm or a direct blow to the elbow, with the olecranon, the radius, and the ulna playing a central role. Depending on the severity of the fracture and the specific fracture patterns, diagnosis and treatment are performed using X-rays; the elbow joint consists of three bones and complex articular surfaces near the elbow joint.

In the case of a non-displaced elbow fracture, conservative treatment with a cast, immobilization of the affected limb, and conservative therapy may be sufficient, whereas complicated elbow fractures involving significant force, hemorrhage within the elbow joint, or involvement of the coronoid process, the ulna, or the humerus, surgical treatment with osteosynthesis and surgical management is often necessary.

After the acute phase, physical therapy is crucial, as physical therapy exercises help prevent restricted movement, stiffness, and joint contractures; improve the range of motion; and restore mobility to the elbow joint.