Elbow & Foream Fractures

Broken Elbow

An elbow fracture is a break in one of the bones which form the elbow joint. There are three bones which could be broken: the Humerus (upper arm bone), Ulna and Radius (two forearm bones). This elbow injury can be caused by a fall or a hard impact, and especially because there can be further potential complications, medical assistance should be sought immediately.


What is an Elbow Fracture?

A fracture is the same thing as a break, there is no difference in the type or severity of the injury and the two words are interchangeable.

There are many ways and areas in which the elbow can be fractured. Usually, it results from a fall directly onto the joint, or a hard impact. Sometimes it can happen from falling onto an outstretched hand or from a strong muscular force. The triceps muscle pulling in the Olecranon process at the back of the elbow is a common example of this.

Due to several main nerves and arteries passing very close to the bones of the elbow, complications due to damage to these structures is common. Any elbow fracture should be fully examined to check for associated injuries.

The most common elbow fractures include:

Fractures of the Coronoid Process

The coronoid process is a protrusion of bone on the Ulna, at the front end of the ‘cup’ in which the end of the humerus sits. This part is fractured through a fall onto a straightened elbow and is often associated with an elbow dislocation.

Symptoms include:

  • Pain
  • Tenderness and swelling over the front of the elbow joint.

Non-displaced fractures can be treated with immobilisation in a cast for 3-4 weeks. Displaced bone fragments may require surgery.

Intercondylar Fractures

An intercondylar fracture is a break to the Humerus (upper arm) bone, between the medial and lateral condyles at the lower end of the bone. Fractures here are described as being Y or T shaped and have varying degrees of displacement of the fractured bone segment. This injury is usually caused by a blow to a flexed elbow.

The patient will usually be holding their arm in a flexed position with the palm facing downwards. The forearm may appear shorter than the other one.

Treatment usually involves surgery as the fragment is usually displaced.

Condylar Fractures

The two prominent parts of the Humerus on either side of the elbow are known as the Epicondyles (or just condyles). A condylar fracture is a break to one of these bones. The outer (lateral) condyle is more likely to fracture than the inner (medial) one. Injury to both is due to impacts or falls.

Symptoms include:

  • Pain, swelling and a limited range of motion
  • It is common to feel a crunching feeling or sound when trying to bend the elbow.

In non-displaced fractures immobilisation in a cast or splint is sufficient. If the fragment has become displaced then surgery is required.

Capitellum Fracture

The Capitellum is the rounded lower end of the Humerus, which articulates with the Radius of the forearm. Fractures to this area occur most often through a fall onto an outstretched hand.

Symptoms include:

  • Pain and swelling at the front of the elbow.

Most fractures are displaced and so require surgical fixation.

Forearm fractures

A broken forearm is a fracture to either the radius or ulna bones which make up the forearm. They are usually caused by a fall onto an outstretched arm. It is common for both bones to break. However, a fracture can occur in just one bone, especially near the wrist.

Acute forearm fractures occur at any point on the bone from the elbow to the wrist. Bones may break into two parts, or cause a fragment to be chipped off. For example, in Olecranon fractures and fractures of the coronoid process.

Symptoms vary depending on the extent and location of the fracture:

  • Instant pain
  • Swelling
  • Tenderness over the specific site of the fracture.
  • Deformity.

An X-ray should be performed to confirm the diagnosis and determine the severity of the fracture, and whether the bone is displaced (moved). If the bones are not displaced treatment will usually involve immobilization of the arm with a cast or splint, for up to 10 weeks to allow the bones to heal.

Where the bone has become misaligned or the fractured fragment has moved away from the rest of the bone, and particularly with fractures occurring in adults, surgery may be required to realign and fix the bones back together. Again this is followed by a period of immobilization.

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