The elbow or elbow joint is one of the most complicated joints in the human body. It consists of three joints that are involved in the movement and rotation of the forearm:
- Humeroulnar joint (joint between the humerus and ulna): serves to flex and extend the forearm,
- Radioulnar joint (joint between the radius and ulna)
- Humeroradial joint (between the humerus and radius): serves to rotate the forearm
The elbow joint is surrounded by a joint capsule. Several ligaments stabilize it. A layer of cartilage at the ends of the bones protects them from wear and tear. The bursa also serve to protect against excessive strain.
Several upper arm muscles are involved in the movement of the forearm. They are connected to the forearm bone via tendons that run across the elbow joint.
Anatomy of the elbow @ bilderzwerg /AdobeStock
Various injuries can occur in the elbow area, such as
- Broken bones (fractures)
- torn ligaments
- bony ligament tears or
- dislocations (dislocations)
A dislocation is defined by the medical profession as the sudden dislocation of a bone from its natural position. Usually as a result of a fall or other external force. The radial head fracture is the most common fracture in the elbow area.
With injuries, there is always a risk of blood vessels and nerves being damaged.
In addition to the injuries mentioned above, elbow surgery experts also treat the following conditions:
Tennis elbow: Also known as tennis elbow or epicondylitis humeri and is caused by regular overuse of the muscles. This leads to inflammation of the muscle insertions on the outside of the elbow. This can be the case with certain sports (such as tennis) or manual activities.
Tennis elbow is characterized by pain on the outside of the elbow that radiates into the forearm and upper arm.
With tennis elbow, the attachment of the muscle tendons on the outside of the elbow hurts @ GraphicsRF /AdobeStock
If the muscle insertions on the inside of the elbow are irritated, this is referred to as golfer's elbow (thrower's elbow, epicondylitis humeri ulnaris).
Ulnar tunnel syndrome(cubital tunnel syndrome) is characterized by a functional restriction of the hand and fingers, which leads to reduced or impaired mobility. This is caused by permanent irritation of the ulnar nerve. It is one of the nerve bottleneck syndromes.
Congenital malformation of the elbow: In radioulnar synostosis, the ulna and radius are fused together. In congenital dislocation of the radial head, the radial head is permanently dislocated.
Elbow osteoarthritis: This is characterized by bone and cartilage wear that goes beyond the normal level, as in rheumatoid arthritis.
In addition to questioning the patient about their symptoms (such as pain, sensory disturbances and functional limitations), the focus is on the clinical examination.
The doctor palpates the elbow joint and the neighboring structures. He looks for misalignments and swelling as well as changes in the color of the skin. He also checks the mobility of the arm and hand (functional tests).
This will already indicate whether a dislocation is present and whether nerves and blood vessels are affected.
If a bone fracture is suspected or to rule out fractures and elbow dislocation, an X-ray examination is performed.
This allows the bones to be visualized very well. An even more precise representation of the bony structures can be achieved with computer tomography (CT). Bleeding, bruising or swelling can also be visualized in this way. It is also used for complex elbow dislocations.
Magnetic resonance imaging (MRI) is more commonly used for injuries to ligaments and soft tissue as well as muscles and bursae.
However, soft tissue structures can also be visualized well with an ultrasound examination (sonography). It is therefore used for bursitis, joint and bruising injuries and injuries to muscles and tendons.
Bursitis of the elbow is usually noticeable through swelling on the back of the joint @ Praewphan /AdobeStock
High-resolution ultrasound devices can even visualize nerves. If a nerve impingement syndrome is suspected, a neurological examination is carried out to determine the nerve conduction velocity.
In some cases, the doctor will use arthroscopy to obtain a precise picture of the inside of the joint.
During this minimally invasive procedure, the doctor can also carry out therapeutic interventions such as the removal of bony structures.
The treatment methods used by elbow surgery experts are
- Arthroscopies (joint endoscopies)
- Minimally invasive procedures
- Open surgery
There are operations to stabilize the elbow joint and to treat injuries and bone fractures. Osteosynthesis, for example, is a surgical connection of individual bones or bone fragments so that they can grow together again.
Elbow surgery also includes the correction of congenital deformities and joint replacement operations as well as the treatment of certain diseases.
The range of services offered by an elbow surgeon includes
- Treatment of tennis elbow
- Treatment of golfer's elbow
- Treatment of nerve constriction syndromes
- Removal of osteophytes (abnormal bone growths at the edge of the bone)
- Removal of free joint bodies
- Treatment of elbow arthrosis
- Treatment of bursitis
- Removal of the synovial membrane in rheumatoid arthritis (synovectomy)
- Treatment of restricted movement and joint stiffness
- Treatment of bone fractures and multiple ligament tears; depending on the severity, the joint must be stabilized using plates and screws.
- Reduction of the dislocated bone in the event of dislocation
