5 Things You Need to Know About Elbow Fractures

1. A Lot of Bones to Break
It is difficult to lump all the types of fractures around the elbow together in one group. There are fractures of the radial head, olecranon, lateral condyle, medial condyle, medial epicondyle, supracondylar humerus, coronoid and capitellum, to name a few.
2. Once Broken, Unlikely to Regain Full Motion
The elbow is a relatively small joint, but very complex. It flexes and extends, but it also rotates. Part of it is like a hinge joint, but part of it is a ball-and-saucer to allow rotation. You can imagine that even small injuries and incongruities in the elbow joint will prevent full motion. The goal of treatment is to regain "functional" range of motion. This is defined as a 100-degree arc of motion in both flexion/extension and rotation. With your elbow at your side, 0 degrees of flexion is your elbow straight, and 90 degrees is your elbow getting ready to arm-wrestle. We shoot for 30 to 130 degrees as the functional arc of motion. In terms of rotation, 0 degrees is when your thumb is pointing straight up, getting ready to give a karate chop to something. A 90-degree supination is your palm facing straight up: "Gimme five!" A 90-degree pronation is your palm facing straight down. We shoot for 50 degrees of supination and 50 degrees of pronation.
3. Functional Range of Motion May Not Require Surgery
Some fractures may appear innocuous at first but can prevent you from regaining functional range of motion. If this is the case, surgery is required to either fix the fracture or take out the pieces of bone that are causing the motion block. But how do you tell with a fresh fracture, when you can barely move the elbow? There's swelling, and it hurts. Sometimes the doctor will use a needle to remove some of the bleeding (aspiration) and inject some numbing medicine. Once the swelling is improved and the pain is deadened, doctors can check the motion again. If there is no mechanical block to motion, surgery might not be necessary.
4. Elbows Get Stiff Fast
Elbows start getting stiff within 7 to 10 days. If the fracture is stable and doesn't prevent functional range of motion, early motion should be started. An elbow brace may be used to give some support.
5. Fracture Line Extending to a Joint Generally Requires Surgery
Unless the fracture is nondisplaced, surgery will be beneficial in aligning the fragments so that the joint cartilage is as smooth as possible. This will hopefully prevent arthritis or at least ward it off as long as possible. This may be accomplished with metal screws, plates, pins or even prosthetic replacements.