Broken elbow

The elbow is the joint between the upper arm and the forearm. The elbow joint makes it possible to bend, extend and rotate the forearm. The joint consists of three bones: the upper arm bone and two forearm bones, the radius and the ulna.

The two most common fractures of the elbow are seen in the ulna and in the radius. A break in the ulna (Latin ulna) usually occurs at the level of the olecranon. This is the large pointed piece of bone, palpable at the bottom of the elbow. In medical terms, this break is therefore also called an olecranon fracture.
The radius (with the Latin name radius), breaks in most cases at the 'head'. Hence the term radial head fracture.

How does a broken elbow occur?

A broken elbow is in most cases a direct result of trauma (an accident). An example of such an accident is a fall on the elbow or outstretched hand, or a hard blow or knock on the elbow. Especially in the case of an olecranon fracture, a fall is almost always the cause. The reason for this is that its superficial position under the skin makes this piece of bone vulnerable to breaking.

By contrast, a radial head fracture is more often seen with a direct blow or knock on the elbow. Think of traffic accidents and contact sports.

Characteristics (symptoms) of a broken elbow

Most characteristic of a broken elbow is a sudden and severe pain at the level of the elbow. Another direct consequence of a broken elbow is that it is no longer possible to move the elbow. The area around the break can swell and become discoloured. Touching the break or moving the elbow causes more pain.

In a severe accident there may be a displacement of bone fragments. As a result, the elbow can look deformed. Due to pressure on the nerves or blood vessels, the fingers on the side of the broken elbow may tingle or be numb.

How is the diagnosis of a broken elbow made?

Usually the patient history and the physical examination already make it clear that there may be a break in the elbow. To confirm this, additional tests will always be done. In most cases this is done by taking an X-ray. On an X-ray the fracture line and the location of the break are clearly visible. A CT scan or an ultrasound can also be chosen. Such scans visualise the bone fragments in even more detail.

Treatment of a broken elbow

The treatment of a broken elbow depends on the type and severity of the break. Often an operation is required to repair the break. This is especially the case with an olecranon fracture. During the operation the break will be fixed using metal screws and plates. This allows the bone fragments to grow back together.

In favourable cases no surgery is needed. The break can then be treated with a number of weeks of plaster. In both cases the elbow must not be moved for at least six weeks.

After this period of six weeks, exercise therapy should be started as soon as possible. Fully bending or extending the elbow is then almost impossible. The exercise therapy is therefore aimed at reducing stiffness in the elbow and strengthening the muscles again. It is advisable to do this under the guidance of a physiotherapist. Treatment forms that the physiotherapist can apply in addition to exercise therapy are mobilisation techniques, dry needling, massage and medical taping.