In this article I’ll cover some common questions about elbow fractures. Patients will elbow injuries often have the same questions about their problem – hopefully you’ll find this useful if you or someone you know has an elbow fracture.
Common Questions About Elbow Fractures
What is the elbow?
Elbows are basically hinge-type joints, like the hinge on a door.
The three bones that make up the elbow are the humerus, radius, and ulna. The humerus is the bone of the upper arm – it flares out just before it connects with the elbow joint.
The radius and ulna are smaller and sit side-by-side in the elbow joint.
Bones of the elbow – courtesy of ASSH
Strong ligaments hold the bones together (ligaments connect bones to other bones).
Muscles and tendons surround the elbow joint and help it move. The elbow is capable of two main types of movement: bending and straightening and rotation (when you turn palm up and palm down).
Either one of these motions may be stiff or painful after a bad elbow injury.
How do elbow fractures happen?
Elbows break most commonly after a fall onto a stretched-out hand, when someone tries to break their fall. You can also break your elbow if you land directly on it, or by twisting it severely. Other injuries like sprains, strains, or dislocations can happen at the same time.
How do I know my elbow is fractured?
Sometimes it’s hard to tell if you have a bruise, a sprain, or a complete break (a fracture). Pain, bruising, and swelling around an elbow that’s hard to bend or twist can be signs of a broken elbow.
You may hear or feel a pop or crack in the elbow during the injury.
Other signs of serious injury include a crooked appearance to the elbow or arm, bleeding cuts in the skin around the elbow, or numbness/tingling in the hand after the injury that doesn’t improve.
How do elbow surgeons diagnose elbow fractures?
X-rays will show most elbow fractures. These are taken in the ER or in the elbow surgeon’s office.
Sometimes it’s necessary to get a CT scan of the elbow, and your surgeon or ER doctor might recommend this. A CT scan is a type of x-ray that looks at the elbow bones in very fine detail – much more closely than with plain x-ray.
Surgeons often get CT scans of elbows if they’re trying to figure out exactly how severe the break is, or to plan for surgery. For example, a CT will show a surgeon if the broken elbow is shattered in hundreds of pieces, or broken into a few main fragments – this will be good to know before starting surgery.
What does treatment for elbow fractures involve?
Elbow fractures are treated either with surgery or without surgery. Usually the right answer depends on how badly the elbow is broken.
- Is the break in the joint?
- Does the break involve multiple bones?
- Is the fracture solid or are there loose fragments in the elbow?
- Is a nerve or blood vessel damaged?
All these questions need to be answered during the decision process.
When splints, casts, or braces are used
If the pieces are stable and not likely to move out of place, a splint or cast may let them heal. Sometimes it’s even safe to move the elbow during the healing process to prevent stiffness.
When surgery is used
If the bones are broken in multiple places or if the break involves the joint, or the pieces are moved out of place a lot, surgery is usually the right answer.
Surgery is used to put the pieces back in the right alignment, solid enough (using metal hardware like screws and pins) to let you move the elbow after surgery (in therapy). If the bone comes through the skin, surgery is needed right away to wash out the cut and prevent infection.
How long is the recovery from an elbow fracture?
Any fracture takes about six weeks to heal. This is true whether you have surgery or just a splint.
Some factors make healing slow down, like smoking or bad circulation.
If the pieces of broken bone can be stabilized in surgery or are stable on their own, early motion and therapy can prevent stiffness, but therapy is usually required on top of the bone healing time.
Therefore count on about three months of total healing and rehabilitation time to recover from an elbow fracture.
Some patients heal faster, some slower. The most common complication after an elbow fracture (with or without surgery) is stiffness.
What Dr. Henley’s Elbow Fracture Patients Are Saying
by Leigh
I broke my right elbow while on vacation and called to make an appointment for when we got home. Was able to get an appointment with Dr. Henley right away and was so very pleased. He is very attentive and kind…started physical therapy within the week of the break. Loved the fact he was so proactive towards my recovery and because of that I was playing golf again at full speed at 10 weeks post injury!!
by Amy Glenn
I broke my left elbow in a bicycling accident in May. I was referred to Dr. Henley by the Washington Regional ER staff. His staff got me in for an apt very quickly and I had a surgery appointment a week later. Dr. Henley has a great bedside manner and makes sure you understand what the problem is and how he is going to fix it.
I turn 40 this year, and this is my 1st broken bone and being the active person I am thought this was going to be a breeze. I would waltz out of surgery…do a little therapy…and all would be better. Poor Dr. Henley…..the surgery went well but scar tissue aggressively set up in my elbow and no matter how hard I worked in therapy and at home I could not get my elbow to bend.
Two things happened at that point that I feel really turned my whole situation around….Dr Henley recommended a manipulation procedure where you go to the outpatient center they put you to sleep and he bends your arm and breaks up the scar tissue. Then my therapist Cindy (wonderful person) recommended a static progressive splint that had to be rented from an outside source. I don’t know if I would have the range of motion I have today without the combination of those 2 things. The one downside of the splint is that Blue Cross insurance did not cover it so I have to pay out of pocket approximately 95/mo but WELL WORTH IT! I was fully released yesterday and I ride much more cautiously now but am back on a bicycle. If anyone in my family is in need of something that Dr Henley can treat, he will definitely be my first choice.
NIRAV SHAH says
HOW LONG DOES IT TAKE TO FILL THE HOLES OF THE SCREW TAKEN OUT OF THE TITANIUM PLATE INSTALLED IN CASE OF ELBOW FRACTURE IN CHILDREN AROUND 10 YEARS OLD
Dr. Henley says
Usually this takes about six weeks, but the only way to tell is for the surgeon to take an x-ray and see if the holes are filling up with new bone.
REBECCA DEVITO says
I had titanium plate in left elbow/forearm since Jan 2008 without further treatment since Feb 2008. I had fall in July 2013 directly on left hand causing much pain to my elbow and forearm. Upon xray Dr. advised screw coming loose in plate and must remove plate. The report states “sprain of unspecified site of elbow and forearm”. Is this the same as screw coming loose in plate in elbow. Are there complications to this surgery. Dr. says very simple operation.
Kindly advise,
thank you
christine says
hi i hurt my arm and went to er they took an xray and told me i had broken my elbow and put me in a sling 2 weeks later i had to go to the fracture clinic after waiting 4 hours they took an xray and told me their was nothing wrong with my arm took the sling off me and told me to go home now 1 week later my arm is still really sore to move. when i lift even a cup of tea or move my arm. my forearm is still slighty swollen and i cant even sleep with the pain . i dont know if i should go back to er or not as i feel i am wasting their time any sugestions?
C. Noel Henley, MD says
Rebecca:
Please see my article on removing plates and screws from the body.
Complications are always possible. A loose screw doesn’t necessarily mean you need surgery unless the screw is irritating your skin or causing joint damage.
The x-ray report doesn’t make sense to me – you can’t “see” a sprain on an x-ray.
CNH
C. Noel Henley, MD says
Christine:
Please find a good hand/arm surgeon where you live. They should be able to tell you if it’s cracked, if you have a bone bruise, and at least get you in to see a good elbow therapist or estimate when this will calm down.
Look for a surgeon who sees elbows all the time.
CNH
Marcia Alder says
I cracked the top of my ulna bone in my elbow falling on ice 15 years ago. I had physical therapy and a splint for several weeks and care from an orthopaedic surgeon. I have had arthritic pain in the joint off and on over the years but have not experienced anything like the original pain of the break until last night out of the blue. I have not reinjured the joint, I was not leaning on it or sleeping on it wrong. Why would the intense pain of the original break suddenly return for now reason? Is t his common?
Sincerely, Marcia Alder Calmejag747@gmail.com
Marion says
My 6 year old daughter broke her elbow falling off the monkey bars.
she has a severe fracture, which required surgery and the placement of 4 pins. she is in a splint and it’s been a week now. she has no pain in her elbow but her hand is very sensitive to touch. her pinky not at all but the ring finger hurts her. going up the fingers the thumb hurts the most. but not on the outisde, just the inside of the hand. is that normal??
C. Noel Henley, MD says
Marion:
This hypersensitivity is not normal. Make sure you let your child’s surgeon know what’s going on within the next few days – make sure he doesn’t think it’s necessary you bring her in a little early.
CNH
C. Noel Henley, MD says
Marcia:
The answer depends on a lot of things. But in general, you can have fairly impressive and bad arthritis but not have horrible pain. Then all of a sudden the pain just starts. Sometimes it’s from hitting it or falling on it, but other times it can start randomly. My guess is that it’s arthritis pain. An elbow specialist should be able to tell you the answer and you’ll likely need an x-ray.
CNH
Ria says
Hi,
I fell on my extended right arm in Sept 2014 while roller skating and broke my elbow joint. I was told at the ER that its a minor fracture and was given a splint (not a cast). However, my elbow bone got displaced within the next 10 days I was told upon re-examination that I needed surgery . Now after a month post surgery (metal pins), I am going through regular physical therapy but my elbow joint is very stiff. I am not able to flex by arm beyond 88 degrees, despite 30 days of regular therapy. I am following the home program given by my therapist (active extension and flexion of the arm, supination and pronation of the wrist etc), but with discouraging results.
I would like to know the average time for a case like me to heal (specifically considering that I was in a sling for 10 days and was not advised surgery right away- does that affect my prognosis in any way?)
Sincerely,
Ria
C. Noel Henley, MD says
Ria: Please tell your surgeon about all of this and your frustrations. I can only give you general advice that may help others.
Fractures of the elbow heal in about six weeks, like any other fracture in the body. This is a general rule.
Some patients get very stiff; others have almost no stiffness; even if the surgery is done perfectly!
It’s very unlikely that the delay in treatment made a difference.
Scar tissue usually stops changing at around 6 months – you have a long way to go before giving up!
Some patients with elbow surgery need scar tissue release surgery – this is not usually done before six months. However, one question I would ask your surgeon is whether a manipulation of the elbow under anesthesia would help or be wise.
CNH