Elbow Fractures
Elbow fractures are breaks in the bones within the elbow. There are multiple types of fractures that can occur in the elbow.
Causes
Most elbow fractures occur when a child falls on an outstretched arm with a lot of force from the fall. This impact can cause a fracture or break near the elbow.
What Makes Up the Elbow?
There are 3 bones that create the elbow joint (the humerus, the radius and the ulna). These bones, along with the ligaments, tendons and muscles allow the elbow to move like a hinge, bending and straightening. The big bone is the humerus, which is in the upper part of the arm. The radius and the ulna are the 2 bones of the forearm (or lower arm). The radius runs along the side of the thumb and the ulna runs along the side of the small finger.
Symptoms
Common symptoms associated with elbow fractures include:
Swelling
Pain
Limited movement
Bruising around the elbow
Diagnosis
After the healthcare provider asks you and your child questions and does a physical exam, you’ll likely go to a room where an X-ray will be taken. The healthcare provider will examine the X-ray to determine the type of elbow fracture your child has.
There are several types of elbow fractures. The most common include:
Supracondylar Fracture:
This is a break in the humerus bone, just above the elbow. These fractures are not only the most common elbow fractures in children under 8 years of age, but also the most serious since some of them can cause problems with circulation and nerve function. While the great majority of these fractures can be managed with manipulation and casting, the most severe one will require surgical manipulation and fixation with pins.
Condyle Fracture:
These are breaks of the bony prominences of the elbow. The most common is a break on the outside or lateral condyle. If these fractures are displaced, they often require surgery to realign the joint properly.
Fracture Dislocation:
A dislocation of the joint between the radius and the humerus with a fracture at the proximal aspect of the ulna bone is called a Monteggia fracture. These injuries require immediate attention. While the majority of them can be managed with a simple manipulation and cast application, some will require surgical fixation.
Olecranon Fractures:
These breaks occur on the bony tip of the elbow. With little muscle or soft tissue covering the bone, it is a common fracture with direct trauma to the elbow.
Radial Neck Fractures:
This is a break of one of the forearm bones near the elbow joint. This fracture is common in children who fall on an outstretched hand. The force of the fall is transmitted from the hand, up the arm to the elbow joint. These fractures are often managed with simple casting, reserving surgery only for those that are severely displaced or angulated.
Treatment
There are several different treatment options depending on the fracture and how severe it is. If the fracture is not displaced, a simple cast is likely to be applied for 3–6 weeks with periodic radiographs. If the fracture is displaced, a so-called “reduction” (pushing the bones back into place) will be required.
If the reduction doesn’t work, or if the fracture is so severely displaced that a reduction would not be sufficient, surgery may be required. Surgery includes placing the bones back into place and then fixing them using pins, screws and/or wires. Most children regain their range of motion 1–2 months after the cast is removed. While in most cases physical therapy is not required, your doctor might decide to prescribe it if the condition is severe enough to require it.
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