Fractures of the elbow are common injuries that can occur from falls, blows to the elbow, or other traumatic events. The elbow is a complex joint formed by the humerus, radius, and ulna bones. Signs of a fractured elbow include swelling, deformity, bruising, and limited range of motion. Treatment depends on the severity of the injury and may involve splinting, casting, medications to manage pain and reduce swelling, surgery to repair broken bones or damaged tissues, and physical therapy. Complications can include infection, stiffness, nonunion of broken bones, nerve damage, and arthritis. Following medical advice is important for proper healing.

1. Fracture of Elbow
Introduction
Elbow injuries are common in both adults and children. Early recognition and treatment
of a fractured elbow injury can reduce the risk of complications and later disability. Any
serious injury of the elbow deserves medical attention.
The elbow is a complex joint formed by 3 bones:
 The humerus is a single bone in the upper arm that runs from the shoulder to the
elbow.
 The radius and ulna, bones of the forearm run from the elbow to the wrist.
 Ligaments, muscles, and tendons maintain the elbow's stability and allow joint
movement.
A normal elbow joint allows these motions:
 Flexion or bending
 Extension or straightening
 Rotation, turning the palm up and down
Serious injuries, such as fractures (a bone break) and dislocations, can damage the
bones and other structures of the elbow, resulting in problems with movement, blood
vessel function, and nerve function. In children, fractures can affect the growth and
development of the bones. This is because children have many bone "growth plates," a
part of the bone where bone growth takes place. Bone growth continues throughout
childhood; if one of these "growth plates" is involved in a fracture, it can affect bone
development.

2. Normal physiology of Elbow
Fractured Elbow

3. Causes
People can injure an elbow in a variety of ways, from overuse (athletic injuries) to an
acute traumatic event (a fall or direct blow). Some common events that result in elbow
fractures:
 Falling backward, for example, off a skateboard, the person may attempt to
brace the fall with an arm outstretched and open hand.
 High-energy trauma can occur in an automobile or motorcycle collision.
 A direct blow on the elbow can cause a break, such as when a person falls off
a bicycle and lands directly on an elbow.
 Sideswipe injury occurs when an elbow is struck while a person is resting an
elbow out an open car window.
 Any other direct injury to the elbow, wrist, hand, or shoulder can fracture the
elbow.
Signs and symptoms
If the elbow shows any of the following signs, a person may have a fracture,
sprained elbow, or another injury that needs medical attention:
 Swelling of the elbow or in the area immediately above or below the elbow
 Deformity of the elbow or the areas near the elbow
 Discoloration, bruising, or redness of the elbow
 Difficulty moving the elbow through its complete range of motion
Movements of Elbow
1) Flexion and extension: Individuals should be able to bend their elbow so
that they can touch the shoulder with the fingertips. Patients also should be
able to fully straighten their arm. If they cannot do this, it may be a sign of a
supracondylar fracture.
2) Inward and outward rotation: When holding the upper arm at the side with
the elbow flexed (bent) at 90 degrees, people should be able to rotate their
hand outward so that the palm faces the ceiling. In this same position, a
person should be able to rotate his or her hand inward so that the palm faces
the floor. If the person cannot do this, it may be a sign of a radial head
fracture.
3) Numbness decreased sensation, or a cool sensation of the forearm, hand,
or fingers

4. Major Nerves
Three major nerves,
1) The median,
2) Radial, and
3) ulnar nerves travel through the elbow. A serious injury may damage one or
more of these nerves.
Treatment
 treatment may be as simple as elevating the splinted arm,
 applying ice to swollen areas,
 And taking pain relievers.
 Treatment can also include surgery to repair bones, nerves, and blood vessels.
Treatmentwith medicines
A wide variety of pain relievers are available for a broken elbow.
 Oral medications are used for mild pain.
 IM or IV injections are used for moderate to severe pain.
 Medication can put directly into elbow joint to relieve pain by injection in
vein.
 If elbow is broken or dislocated, it needs to be reset.
 Muscle relaxants can also be given to patients.
Surgery
Sometimes an operation to repair a broken elbow is the best choice. This
is particularly true if there is an open or compound elbow injury.
 An open elbow injury means that one or more of the bones at the elbow
has come through the skin.
 The bone needs to be put in place and to be thoroughly cleaned so the
infection does not occur. This is generally performed by a surgeon.
 Elbow injuries that damage nerves and blood vessels often need to be
fixed with surgery. The doctor (usually an orthopedic specialist) will
discuss the treatment options with the patient.
Other therapies
If the elbow joint is filled with blood or other fluid, the
joint can be drained. Blood or other fluid drained from the elbow may
suggest a particular diagnosis to the doctor. Draining this fluid may relieve
pressure and pain in the elbow.
1. Splints, slings, and casts
2. Resetting broken elbows.

5. Follow up
It is extremely important to follow a doctor's medical advice to get the best possible
result. Keep all follow-up appointments.
 Use medications such as acetaminophen or ibuprofen to reduce pain and
swelling.
 Elevate the arm to reduce pain and swelling.
 Leave the splint or cast in place.
 Take antibiotics to treat infection, if prescribed, or to reduce the chance of getting
an infection.
 Return to the emergency department immediately if any of the following is
noticed:
 The hand is cold, pale, or blue
 The hand is numb, tingling, or feels "asleep"
 The forearm hurts when the wrist, hand, or fingers are moved
Prognosis
1) Infection: Open injuries - when one of the elbow bones comes through
the skin-have a higher infection risk. Bacteria can enter the bone or joint
and cause infection.
2) Stiffness: Many elbow injuries result in elbow stiffness. The injured elbow
may not flex, extend, or turn as much as it once did. This usually is more
common in adults than in children.
3) Nonunion: A broken bone that does not grow back together is called
nonunion. Nonunion of a broken elbow can be treated by replacing the
elbow with an artificial joint or by bone grafting. Bone grafting involves
placing additional bone around the area of the nonunion.
4) Malunion: Malunion occurs when healing bones grow back together in an
abnormal way. The bone may be bent or twisted. An operation may be
required to fix this problem.
5) Abnormal bone growth: A broken bone repairs itself by forming new
bone. As a broken elbow heals, this new bone may form in areas where
bone does not usually grow.
6) Arthritis: Arthritis literally means joint inflammation. After a severe injury,
people can develop a type of arthritis that may make a joint painful and
stiff. This may worsen with cold weather or overuse.
7) Nerve damage: The three nerves that run through the elbow can be cut,
contused, kinked, or pulled in an elbow injury. The resulting nerve damage
may be temporary or permanent. Swelling after an elbow injury can press
on nerves causing damage.
8) Hardware problems: Doctors sometimes repair broken elbows with
wires, pins, screws, plates, and other pieces of hardware. If any of this

6. hardware moves, it may cause pain or unsightly bumps under the skin. If
this occurs, the hardware may need to be removed.
9) Blood vessel damage: A large artery runs very near the elbow joint to
supply blood to the forearm, wrist, and hand. Certain elbow injures may
cut or kink this artery. Sometimes resetting the broken elbow will relieve
pressure on the artery. Sometimes patients may need an operation to
speed recovery..
(Submitted by MeerabTanveer )