Elbow Fractures
Who is a candidate for surgery?
The elbow is a complex joint made up of three bones—the humerus (upper arm bone), radius, and ulna (forearm bones). A fracture can involve one or more of these bones, and treatment depends on the pattern of injury. Some fractures can be treated without surgery if the bones remain stable and well-aligned. However, when the bones are displaced, unstable, or involve the joint surface, surgery may be necessary to restore motion and function.
Types of elbow fractures
Radial head fractures – Common after falls, especially when landing on an outstretched hand. Some small fractures heal without surgery, but displaced or unstable fractures may need fixation or replacement.
Olecranon fractures – Involve the bony tip of the elbow. Because the triceps tendon attaches here, many olecranon fractures require surgery to allow normal extension of the elbow.
Distal humerus fractures – Breaks at the lower end of the upper arm bone. These often extend into the joint and usually need surgery with plates and screws to restore alignment.
Monteggia fractures – A break in the ulna bone combined with dislocation of the radial head. These are unstable injuries that almost always need surgery to fix the ulna and restore stability to the joint.
Terrible triad injuries – A complex combination of elbow dislocation, radial head fracture, and coronoid process fracture. These high-energy injuries require careful surgical repair to restore stability and motion.
What does surgery involve?
Surgical treatment (ORIF: open reduction and internal fixation) involves carefully realigning the broken bones and holding them in place with plates, screws, or wires. In some cases, such as severely damaged radial head fractures, part of the bone may be replaced with a prosthesis. The goal is to restore the shape of the joint, allow early motion, and prevent long-term stiffness.
What are the potential downsides or risks?
Elbow fractures are challenging because the joint is prone to stiffness and scar formation. Even after successful surgery, some loss of motion is common. Risks include infection, nerve irritation, hardware problems, or arthritis developing later. Complex fractures (such as terrible triad or distal humerus fractures) carry higher risks and sometimes require additional surgeries.
What is recovery like?
Recovery varies depending on the type and severity of fracture. The elbow is often supported in a splint or brace at first, but early motion is encouraged once the repair is stable enough. Physical therapy is critical to restore bending, straightening, and rotation. Healing can take 3–6 months, and regaining full strength and motion may take longer. Some patients may not regain a completely “normal” elbow, but with proper care, most can return to daily activities and sports.