Elbow fracture

What is an elbow fracture?

It is a crack or break in one of the bones of the elbow.

What are the bones of the elbow?

The elbow joint is made up of three bones:

• The humerus (the upper arm bone)
• The ulna (the first bone of the forearm)
• The radius (the second bone of the forearm)

One or more of these three bones can be fractured. The most common elbow fractures are:

• Radial head fracture (the radius)
• Olecranon fracture (the part of the elbow you lean on, which is the ulna)

What are the causes of an elbow fracture?

A fracture is always caused by an accident, a blow, or a twist. There must be a clear traumatic event. Common causes of elbow fractures are:

• Falling on the elbow or hand
• Impact directly on the elbow (by a heavy object, for example)

"So, if the pain appeared slowly and gradually, without any clear accident, it is probably not a fracture."

What are the symptoms of an elbow fracture?

The main symptoms are:

• Elbow pain that appeared after a fall or accident
• Weakness and pain in the arm when lifting loads and clenching the fist
• Pain, stiffness, and difficulty bending and straightening the elbow (often unable to fully extend the elbow)
• There may be swelling and bruising on the elbow

There may or may not be a visible deformity of the elbow.

How to diagnose an elbow fracture?

Diagnosis is possible with a review of the symptom history, a clinical examination, and an X-ray of the elbow.

If you have any of the following signs, you should get an X-ray to check for a possible fracture:

• Inability to fully extend your elbow
• Visible deformity of the elbow
• The pain has not improved after 7-10 days.

Did you know that physiotherapists can prescribe X-rays if the injury occurred less than 72 hours ago? If you do not have quick access to a doctor, you can obtain this prescription from a physiotherapist.

When should you see a physiotherapist for an elbow fracture?

Your doctor should refer you to a physiotherapist after establishing a treatment plan for the fracture.

Here are some guidelines for when to see a physiotherapist.

• If your treatment plan does not require a cast, start physiotherapy immediately.
• If you need to wear a cast and experience pain while wearing it, consult a physiotherapist.
• If you are wearing a cast and have no pain, wait until the cast is removed, then start physiotherapy immediately.

If you are unsure what to do, you can consult a physiotherapist who will guide you in the right direction. If they believe a consultation with a doctor is necessary, they will let you know.

What are the physiotherapy treatments for an elbow fracture?

Your physiotherapist will perform an assessment to determine your limitations by evaluating the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

Based on the assessment results, your physiotherapist will:

• Will mobilize your elbow to reduce pain and improve your movement.
• Will give you specific exercises to re-educate:
  
  • Controlling elbow movements
  • Elbow stability and strength
  • Elbow mobility
• Will give you exercises to reduce pain
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

What to do at home for an elbow fracture?

While waiting to see a doctor or your physiotherapist, immobilize your arm against your body with your hand on your stomach using a splint or triangular bandage (you can find this type of bandage at the pharmacy). Follow the doctor's instructions carefully so that the fracture heals well while waiting to start physiotherapy.

Here are some other tips that may help at home:

• Support your arm with a cushion under your armpit, an armrest, or by putting your hand in your pants pocket to elevate your shoulder.
• If you have pain at night or morning stiffness, make sure your neck is well supported while sleeping with a pillow that fills the hollow of your neck. Avoid sleeping with your arm behind your head or under the pillow. Keep your arm along your body or supported with a pillow.
• Avoid sleeping on the painful side.

Sources

Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higginson I, Klein JA, Le Roux S, Saranga SS, Taylor R. Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children. Bmj. 2008 Dec 9;337.