Breaks in the bones of the elbow joint, often due to trauma.
The elbow joint is formed by three bones meeting together: the humerus in the upper arm, and the radius and ulna in the forearm. A fracture may involve any of these bones, with the radial head, at the top of the forearm bone on the thumb side, and the olecranon, the bony point of the elbow, among the most commonly affected.
Elbow fractures vary widely in severity, from simple cracks that remain in good position to more complex, displaced fractures involving multiple fragments. The pattern of the fracture, rather than the bone involved alone, largely determines the right treatment approach.
Elbow fractures most commonly result from a fall onto an outstretched hand, which transmits force up through the forearm to the elbow, or from a direct blow to the elbow itself. Higher energy injuries, such as sporting collisions or motor vehicle accidents, tend to cause more complex fracture patterns, while lower energy falls in older adults with weaker bone can still result in significant fractures.
Common symptoms following an elbow fracture include:
Any of these symptoms following a fall or direct blow to the elbow warrant an X-ray, as some fractures, particularly subtle radial head fractures, can be easy to miss without imaging.
Assessment includes examination of elbow movement, stability and the surrounding nerves and blood vessels, together with X-rays to characterise the fracture. A CT scan is sometimes used for more complex fracture patterns to help with surgical planning.
Stable, non-displaced fractures are often managed with a period in a splint or sling, followed by early, guided movement to reduce the risk of stiffness, a particular concern at the elbow.
Displaced or unstable fractures generally require surgical fixation, using plates, screws or wires to hold the fragments in the correct position while they heal. In some radial head fractures that are too damaged to repair, the fragment may need to be removed or replaced rather than fixed.
Most elbow fractures heal well with appropriate treatment, whether managed with a splint alone or with surgery. Because the elbow is prone to stiffness after injury, some residual reduction in the full range of movement is common even after good healing, which is one reason early, guided movement is emphasised during recovery where appropriate.
More complex or displaced fractures carry a somewhat higher risk of ongoing stiffness or, less commonly, arthritis developing later, which is one reason accurate realignment at the time of treatment matters.
Elbow fractures range from stable injuries that heal with a short period of splinting to more complex fractures needing surgical fixation. Prompt assessment and, in appropriate cases, early movement are important for the best long-term recovery of elbow motion. Persistent pain, swelling or restricted movement after an elbow injury is worth having assessed with an X-ray.
