An elbow fracture can be a painful injury. It can lead to decreased mobility in your arm, shoulder or wrist. An elbow fracture also can limit your ability to work, perform household chores, or participate in recreational activities.
The elbow is a joint where the arm bone (humerus) meets the bones of the forearm (radius and ulna). The bony end of the ulna is called the olecranon process. This is the bone that you feel when you are leaning your elbow on a table. There are many muscular attachments around the elbow that help you move your arm, wrist and hand. The bones of the elbow are connected together by ligaments on the inner and outer part of your arm.
Causes of Elbow Fractures
It may seem obvious, but the most common cause of elbow fractures is trauma to your arm near your elbow. This can be due to falls on your elbow or outstretched arm, automobile accidents, or sports related injuries.
Signs of Elbow Fracture
Common signs of a broken elbow include:
- Pain in the elbow, upper arm, or forearm
- Swelling around the elbow
- Bruising or discoloration around the elbow
- Loss of motion around the elbow or forearm
- Deformity (such as a lump or bump) near the elbow or arm
If you suspect you have suffered an elbow fracture, you must seek medical attention immediately. Failure to report to your doctor or local emergency department may cause permanent damage or loss of function in your arm and hand.
How is an Elbow Fracture Diagnosed and Fixed?
An x-ray is used to diagnose an elbow fracture. The x-ray can show the placement of the bones and can help your doctor decide the best way to fix your fractured elbow. Occasionally a CT scan is used to get a better view of the bones of your elbow and to see if the joint surfaces in your elbow are injured.
After a diagnosis of a fractured elbow is made, your doctor will reduce the fracture. This is the process where your elbow bones are put in the correct position so that optimal healing can take place. Reduction of a fractured elbow can be done manually. If the fracture is severe, you may require a surgical procedure called an open reduction internal fixation (ORIF) to help align the bones. Your doctor will help you understand what method is necessary to reduce your fractured elbow.
After your elbow fracture is reduced, you may be required to wear a brace or a sling. Occasionally a cast will be applied, although it is felt that immobilization of an elbow fracture with a cast may cause severe stiffness and permanent loss of mobility.
Physical Therapy after Elbow Fracture
A major problem after an elbow fracture is stiffness that limits range of motion. Sometimes, this stiffness persists long after the fractured bones have healed. Therefore, your doctor may have you start physical therapy soon after injury to help introduce early motion to your healing elbow.
Your physical therapist may work with you to help you regain normal use of your elbow and arm. He or she may use many different physical therapy treatments and modalities to help you quickly return to normal activity. Some impairments that you may work on in physical therapy may include:
Range of motion: One of the main goals of physical therapy after an elbow fracture is to restore normal range of motion to the elbow. The elbow is a complex joint that allows you to bend your arm or turn your hand over. Working on restoring full range of motion of the elbow and forearm is paramount to regaining normal use of your arm.
If your range of motion loss is severe, your physical therapist may have you wear a dynamic splint. This is a spring loaded splint worn throughout the day that provides a low-load stretch to your elbow joint to help improve range of motion. The splint can be used to improve flexion (bending) or extension (straightening) of your elbow.
Strength: After an elbow fracture, pain and swelling around your elbow may keep you from using your arm. You may also be required to wear your arm in a sling, thus limiting the use of your elbow, wrist and hand. If you have had an ORIF to reduce your elbow fracture, the muscles around the surgical incision may need time to heal. This period of disuse may cause a significant loss of strength around your elbow, shoulder, wrist and hand.
Your physical therapist can teach your strengthening exercises for your shoulder and elbow. He or she can also prescribe exercises to help improve wrist and hand strength that can help you regain normal use of your arm.
If you are wearing a sling, you physical therapist can also teach you the proper way to wear the sling.
Pain and swelling: After an elbow fracture, you may experience swelling around your elbow. Your physical therapist can help you manage the pain and swelling with various modalities like electrical stimulation and ice.
Scar tissue: If you have had an ORIF to reduce your elbow fracture, your physical therapist help you manage the scar tissue that may be present as a result of the surgery. Scar tissue massage and mobilization may be necessary to help improve scar mobility. Your physical therapist can teach you self-massage techniques that you can perform at home.
Getting Back to Normal
Your elbow fracture should be fully healed about two months after injury and you should have normal use of your arm about three months after injury. It is quite common to still experience some mild loss of mobility after this time, so it is very important to continue the range of motion and strength exercises that you learned in physical therapy. Be sure to discuss with your doctor what outcome is expected in your specific situation.
Physical therapy after an elbow fracture can be helpful in safely starting early mobility. It can also help you restore normal strength and function in your arm while helping to manage the pain and swelling that you may experience. Working closely with your doctor and physical therapist can help you quickly and safely return to normal activity after an elbow fracture.
Hertling. , & Kessler, R. (2005). Management of common musculoskeletal disorders:physical therapy perinciples and methods. (4 ed.) Lippincott Williams and Wilkins.