Elbow Fracture

Avoid ending up with limited range of motion, a common complication of an elbow fracture, by following your rehabilitation program diligently. This may include physical and/or occupational therapy.

An elbow fracture is a partial or complete break in one of the bones of the elbow complex.

Anatomy
The elbow is a complex joint connecting the upper arm bone (humerus) and the forearm bones (radius and ulna). These bones work together to allow you to bend and straighten the elbow and rotate your forearm. The ulnar and median nerves and brachial artery are potentially at risk in a displaced fracture at the elbow.

Symptoms
Elbow fractures are usually the result of a strong blow or fall. Symptoms include pain, swelling and tenderness around the fracture site. You may experience a loss of feeling in your arm if blood vessels or nerves are damaged.

Treatment
Immediate Care for Open Fractures: If the skin has been broken, use a clean dressing on the wound to stop the bleeding. Apply an ice pack wrapped in a towel to control swelling. Immobilize and elevate the arm and get to an emergency room immediately.

Medical Care: Your doctor will examine the fracture and ask questions about the injury and your symptoms. X-rays will help identify the location and extent of the break. You may also need a tetanus shot if the bone has broken through the skin.

• Non-operative treatment: Hands-on manipulation will be used to align the bone, after which a long arm splint will hold it in place. In addition, a sling may be used to support your arm.
• Operative treatment: If necessary, the bone is surgically set with hardware such as pins, plates and screws. Surrounding soft tissues can also be repaired at this time. Again, a splint will be applied to cover the area, and a sling may be used to support your arm.

Anesthesia and muscle relaxants may be used when the bone is set or during surgery. Your doctor may recommend medications for pain relief while you heal.

Recovery
During the healing phase, ice packs can be applied for the first 24 to 48 hours or longer to control inflammation and swelling. Once the splint is removed, you may use ice massages three to four times a day for 10 to 15 minutes at a time. Generally, adults require six to right weeks for the fracture to heal, while children need approximately four to six weeks.

The goal of rehabilitation, which continues for 3 or more months, is to restore arm function and help you return to your regular activities as soon as possible. Your doctor may refer you for individualized physical and/or occupational therapy. The outcome largely depends on the extent of your injury, type of treatment, your health before the injury and how well you follow the rehabilitation program.

Complications
Limited range of motion is the most frequent complication with elbow fractures. It is critical that you follow your rehabilitation program precisely to avoid this immobilizing condition. Other complications to watch for include:

• Infection
• Malunion (angulated but healed bone)
• Nonunion (fracture that does not heal)
• Bone shortening or deformity
• Nerve injury
• Impaired blood circulation.