How Do You Know if You’ve Fractured Your Elbow?
A good indication of whether you have a broken/fractured elbow is if you experience substantial pain within your elbow joint and surrounding area with any attempts to move your elbow through its full range of motion.
Signs and symptoms of a broken /fractured elbow may include:
- Substantial pain when bending and straightening the elbow
- Pain with rotating your hand between palm up or palm down)
- Rapid onset of swelling and bruising at the injury site
- Inability to move the elbow
- Immediate numbness or tingling in the ring finger, pinky finger, or both.
- An open wound at or near the injury site with additional pain from range of motion
How Painful Is a Broken/Fractured Elbow?
The pain level from a fractured elbow may vary from patient to patient. Typically, patients feel an acute, sharp pain—particularly with activities that require the elbow to go through a full range of motion. Patients who have these symptoms after an injury should be evaluated by a physician immediately.
Do All Elbow Fractures Require Surgery?
No, not all elbow fractures require surgery. Generally, non-displaced or minimally displaced radial head fractures can heal well without surgical intervention. Pain from these types of fractures is typically felt on the outside of the elbow and may be treated with a sling or splint for a short period of time.
However, fractures that cause the elbow to be unstable, or prevent full elbow range of motion are commonly and most effectively treated with surgery—helping to ensure patients can return to full function and full range of motion.
What Is an Elbow Dislocation (Dislocated Elbow), and How Is It Treated?
An elbow dislocation usually occurs from circumstances that involve a fall on an outstretched hand with a force that causes the elbow to dislocate.
If it is a simple dislocation, which means it does not have an associated fracture, it can usually be reduced (put back in place) in the ER under sedation or with numbing medication injected into the joint.
If the elbow is stable after it is reduced, surgery is not required. However, there is a prescribed period of activity modification and elbow protection, as the soft tissues heal after a dislocation event.
What Types of Elbow Injuries Require Surgical Intervention?
There are several different types of elbow injuries or fractures that may require different surgical techniques:
1). Terrible Triad Elbow Fracture Dislocation – A combination injury that includes a coronoid fracture, a radial head fracture, and an elbow dislocation. If this injury pattern is not addressed surgically with open reduction and fixation, there is a very high risk of elbow instability, pain, stiffness, and post-traumatic arthritis that could significantly limit function. Operative treatment involves either fixation or replacement of the radial head, fixation of the coronoid, and reduction of the dislocated elbow.
2). Radial Head Fracture – A common injury that may be treated non-operatively if the radial head is either minimally displaced or non-displaced. However, if a large fragment of bone has fractured off and is displaced, surgery is recommended to fix the fracture or replace the radial head. If left untreated, there is a high risk of elbow pain, stiffness, and post-traumatic arthritis that could significantly limit function.
3). Olecranon Fracture – A break of the bone at the tip of the elbow. . Displaced olecranon fractures almost always require surgical treatment, in the form of open reduction and internal fixation either with plates and screws or with a pin and cerclage wire tension band construct. The elbow is generally immobilized in the 2-week postop period, followed by early return to range of motion to decrease the risk of elbow stiffness.
4). Distal Humerus Fracture – A fracture at the end of the humerus (upper arm bone)which may or may not include the joint. Displaced distal humerus fractures most often require surgical treatment to restore stability and maximize function.
How Long Is Recovery and Physical Therapy After a Fractured Elbow?
The primary goal of elbow surgery is to provide a stable elbow joint that allows a patient to regain range of motion and function. Physical therapy involves splint removal and the start of a range of motion protocol for 6-8 weeks.
After range of motion is regained and the elbow is healed, the focus is then shifted towards strengthening exercises Physical therapy for motion and strengthening is completed through a combination of office-based therapy and a home exercise program.
Therapy and recovery time can vary based on the nature of the elbow injury or fracture, as well as the patient’s functional baseline. In general, heavy lifting and repetitive use are discouraged until bony healing has been confirmed.