Patient education: Elbow fracture (The Basics)

What is an elbow fracture? — An elbow fracture is a break in 1 of the bones near the elbow. A "fracture" is another word for a broken bone. The elbow is a joint made up of 3 bones (figure 1):

●Humerus – The humerus is the bone that runs from the shoulder to the elbow.

●Radius – The radius is 1 of the bones in the forearm, the part of the arm between the elbow and the wrist. It is on the thumb side of the forearm when the palm is facing up.

●Ulna – The ulna is the other bone in the forearm. It is on the "pinky side" of the forearm when the palm is facing up.

There are different types of fractures, depending on which bone breaks and how it breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

If a broken bone sticks out of the skin or can be seen through a wound, doctors call it an "open" fracture. If the bone does not stick out of the skin or cannot be seen through a wound, doctors call it a "closed" fracture.

An elbow fracture can happen because of a direct blow to the elbow, or falling on the elbow or on an outstretched arm.

What are the symptoms of an elbow fracture? — Symptoms depend on which bone breaks and the type of break it is. Common symptoms can include:

●Pain, swelling, or bruising over the area

●The area looking abnormal, bent, or not the usual shape

●Not being able to move or put weight on that part of the body

●Numbness in the area of the broken bone

If a fracture injures a nerve, this can also cause symptoms in nearby areas. For example, a break to the upper arm bone (humerus) near the elbow might cause pain, tingling, or weakness in the forearm, wrist, hand, and fingers.

Is there a test for an elbow fracture? — Yes. The doctor or nurse will ask about your symptoms, do an exam, and take an X-ray. If you have a complicated elbow fracture, they might also do other imaging tests, such as a CT, MRI, or ultrasound. Imaging tests created pictures of the inside of the body.

During the exam, the doctor or nurse will look at and feel the injured elbow and check the pulse in your wrist. They will also ask you to do some simple finger movements, such as pinching something, spreading the fingers, or giving a "thumbs up." This can show if the fracture caused any nerve damage.

How are elbow fractures treated? — The treatment depends, in part, on the type of fracture and how serious it is. The goal is to have the ends of the broken bone line up with each other so the bone can heal.

If the ends of the broken bone are already in line with each other, the doctor will put on a cast, splint, or brace. This will keep the bone in the correct position so it can heal.

If the ends of the broken bone are not in line with each other, the doctor will need to line them up:

●Sometimes, they can move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. This is called "closed fracture reduction."

●For more serious fractures, they might need to do surgery to put the bone back in the correct position. During surgery, they can use screws, pins, rods, or plates to fix the bone inside the body. This is called "open fracture reduction."

After the fracture is treated, you will also need to see an orthopedic surgeon regularly until the elbow fully heals. This is a doctor who is also a bone specialist. During these visits, the orthopedic surgeon will decide how long you should wear a splint or cast. They will also take X-rays to make sure that the bones are lined up correctly and healing well.

How do I care for myself at home? — To care for yourself or your child at home:

●Follow the doctor's instructions for wearing the splint, brace, or cast. This supports and protects the bone as it heals. Some fractures are placed in a cast right away. Other fractures are not put in a cast until after the swelling goes down. You might also get a sling to support your arm.

●Do not get a cast wet unless the doctor says that it is waterproof.

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

●Gently move the fingers and wrist throughout the day to keep them from getting stiff.

●Prop the injured arm on pillows, keeping it above the level of the heart. This might help lessen pain and swelling. This is especially important for the first few days after the injury.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Some people get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these medicines.

●Ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the cast or splint.

•Use the ice (or other cold object) for at least 1 to 2 days after the injury. Some people find it helpful to ice longer, even up to 3 to 5 days after their injury.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2)

●If you smoke, try to quit. Broken bones take longer to heal if you smoke.

●Some people need to work with a physical therapist (exercise expert) after their fracture heals. The physical therapist will suggest exercises and stretches to strengthen the elbow and arm muscles and keep them from getting stiff.

When should I call the doctor? — Call for advice if:

●There is less feeling or movement in the fingers.

●There is pain when stretching out the fingers or more pain in the forearm.

●The elbow or arm becomes swollen or starts to hurt more.

●The skin becomes red or irritated around the cast, or redness starts to spread up the arm.

●The splint or cast feels too tight and uncomfortable, or the fingers turn pale, blue, or gray.

●There is a bad smell or drainage coming from the splint or cast.

●The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

●The cast gets wet, and it is not supposed to get wet.

If any of the above symptoms seem severe, or if you are concerned but cannot reach the doctor or nurse, seek emergency help. These things don't always mean that there is a serious problem, but seeing a doctor or nurse is the only way to know for sure.

More on this topic

Patient education: Fractures (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Quitting smoking (The Basics)

Patient education: Cast and splint care (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)
Patient education: Quitting smoking (Beyond the Basics)