Sussex Hand CONDITION Surgery Elbow Fractures

CONDITION

An elbow fracture might include What are any or all of the bones near the joint. Treatment and prognosis is Elbow Fractures? very variable.

Which bones are How do I know I have What treatments are 3. Repair of stabilising ligaments. commonly broken in broken my elbow, not available for elbow This is done if necessary at the the elbow? just sprained it? fractures? same time as fixing the bones. The elbow joint is made up of three A displaced fracture may be very All elbow fractures are helped by 4. Replacing damaged parts. This is bones; the far end of the upper arm obvious with deformity, swelling, elevation of the limb (to get the done for the most severe fracture bone called the humerus and the bruising and pain. Undisplaced swelling down) and painkillers. types in adults only. The top part near end of the two forearm bones, fractures can be quite difficult to Application of ice packs can of the radius (the circular part on the radius and the ulna. pick up without xrays. If in doubt sometimes also help. the picture above) can be replaced obtain expert advice early on to alone (radial head replacement). In Many elbow fractures can be make sure you are put on the path older patients with soft bone in Normal Elbow treated without an operation but to show the Joint to recovery as quickly as possible. multiple small fragments replacing good advice regarding appropriate the whole elbow joint can How is the diagnosis made? support and exercises to regain occasionally be the best option maximum function as quickly as (total elbow replacement). Xrays usually confirm the possible is important. The adult diagnosis. elbow stiffens up very quickly if 5. External fixation. This involves using pins into the bone connected Some fractures are difficult to see, kept still so early movement is to bars and a hinge outside the arm. particularly in children. This is often the key to a good recovery. The whole thing looks rather like a because much of the joint in small Some fractures in the elbow do not Meccano set when it is finished. This children is not seen on the Xray as do well if left to heal by is used in extreme cases to support the bones don’t have much themselves. Generally these are repairs of injuries involving both calcium in them until they have ones that involve the joints and bones and stabilising ligaments finished growing. If there is doubt those that are very badly displaced injecting dye into the joint will (out of their normal position). After all these operations swelling Any of these bones can be broken. outline the growing bones. This is Under these circumstances options and stiffness of the whole arm can The break might be described as called an arthrogram. In small that might be considered include: be a problem. Regular exercises for ‘intra-articular’ (involving the children this is often done with all the joints to regain maximum smooth joint surface) or ‘extra- them asleep in theatre and any 1. Manipulation Under function as quickly as possible are articular’ (not involving the joint). necessary treatment can then be Anaesthesia (MUA). This involves essential. Your surgeon will advise They can be displaced (out of the undertaken immediately. moving the broken bones about to you regarding this. normal position) or undisplaced try and realign them whilst you (well lined up). Sometimes you In some cases the fracture pattern are asleep. The new position might might hear them described as is quite complicated and further be supported with small wires What is the outcome ‘comminuted’. This means the details can be obtained using through the skin into the bone (K after an elbow fracture? computerised tomography (CT) fracture is in several pieces. wires) and a plaster. This This is very variable and depends scans and/or magnetic resonance Certain fracture patterns are more treatment is most frequently used on the age of the patient, the imaging (MRI) scans. This will help common in certain age groups. for some children’s fractures. seriousness of the injury and the your surgeon plan the best exercises undertaken after the treatment for you. 2. Open Reduction and Internal Fixation (ORIF). This involves injury. The vast majority of injuries opening the skin and tissues around do very well. The commonest the bone and putting the bone bits problem is stiffness, often with a back together, like a jigsaw puzzle. loss of the last bit of elbow After this the bone fragments are extension (straightening out of often held with plates and screws the arm). Your surgeon will advise inside, on the bone. you regarding the prognosis for your particular injury pattern.

www.sussexhandsurgery.co.uk These notes are intended as a guide and some of the © Sussex Hand Surgery details may vary depending on your individual January 2018 circumstance and at the discretion of your surgeon.