Elbow Fractures
What is it?
What is it?
The elbow is a complex joint made up of 3 bones: the distal humerus (lower region), the proximal ulna (the upper region of the ulna) and the proximal radius. Thus, an elbow fracture can involve each of these bones individually, a combination of two bones or all of these structures. The severity of the injury depends on the type of fracture and the number of bones involved. In this article we will only describe the most common fractures.
Epidemiology
Epidemiology
Elbow fractures have a bimodal distribution with a peak during adolescence and another in old age. Fracture of the radial tachygram (proximal region of the radius) is the most common elbow fracture, followed by fracture of the olecranon (proximal region of the ulna).
Mechanism of injury
Mechanism of injury
It can occur due to direct or indirect trauma and is often associated with elbow fracture-dislocations.
Signs and symptoms
Signs and symptoms
Depending on the fracture, there may be different manifestations:
- A fracture of the radial tachycardia is normally associated with deep elbow pain, without deformity, which allows elbow movements, thus leading the patient to seek medical help only several days after the trauma when there is no improvement in the pain.
- Fracture of the olecranon (proximal region of the ulna) is associated with edema of the posterior region of the elbow and the inability to perform elbow extension.
- More complex fractures, including elbow fracture-dislocations, present with evident deformity of the elbow after trauma with complete functional disability.
Diagnosis
X-ray
X-ray
Allows fracture diagnosis in most situations.
Computerized Tomography (CT)
Computerized Tomography (CT)
Useful when there is doubt regarding the existence of a fracture and in the treatment decision-making process.
Treatment
Treatment
Conservative
When to perform? In radial tachycardia fractures without displacement.
Treatment options?
Treatment options?
Immobilization 1 to 2 weeks
Prognosis
Generally good
Surgical
When to perform? In practically all elbow fractures except for non-displaced elbow fractures.
Procedure/technique – Osteosynthesis/ Fixation of fragments with screws, with or without a plate.
Postoperative
Postoperative
The patient may be discharged on the day of surgery or the following day.
- Use of brachial suspensory for a period of 2 to 4 weeks.
- Surgical stitches must be removed after 2 weeks.
- You can start passive mobility exercises the day after surgery.
When to seek an Orthopedic Specialist?
When to seek an Orthopedic Specialist?
Whenever elbow pain persists after trauma or another doctor has diagnosed an elbow fracture.