At Shoreline Orthopaedics, our orthopaedic surgeons use a truly collaborative approach so our patients have the benefit of multiple expert opinions, without having to go elsewhere to obtain them.
Shoreline Orthopaedics provides more comprehensive services, state-of-the-art options, technologies and techniques than anyone else in the area.
The following information is provided to help you understand what you can expect from us regarding policies and procedures, and also what is expected of you before and after treatment or procedures.
The elbow is a complex joint that allows bending and straightening (flexion and extension), and forearm rotation (pronation, palm down; and supination, palm up). The elbow is formed by the joining of three bones: the upper arm (humerus), the forearm on the pinky finger side (ulna), and the forearm on the thumb side (radius). The radius bone goes from the wrist to the elbow. The radial head is at the top of the radius bone, nearest the elbow.
The surfaces of these bones, where they meet to form the joint, are covered with articular cartilage, a smooth substance that protects the bones and acts as a natural cushion to absorb forces across the joint. A thin, smooth tissue, called synovial membrane, covers all remaining surfaces inside the elbow joint. In a healthy elbow, this membrane makes a small amount of fluid that lubricates the cartilage and eliminates almost all friction as you bend and rotate your arm.
Held together by muscles, ligaments and tendons, the elbow is a combination hinge and pivot joint. The hinge part of the elbow allows the arm bend like the hinge of a door, while the pivot part makes it possible for the lower arm to twist and rotate. There are several muscles, nerves and tendons that cross at the elbow.
Although attempting to break a fall with outstretched hands may be an instinctive response, the force of the impact can travel up the forearm and result in a dislocated elbow or break in the radius, which often occurs in the radial head. Many elbow dislocations also involve fractures of the radial head. Radial head fractures occur in approximately 20% of all acute elbow injuries, are more frequent in women than in men, and are more likely to occur between 30 and 40 years of age.
The most common symptoms of a radial head fracture include:
Fractures are classified by type, according to the degree of displacement, or how far out of normal position the bones are.
Your orthopaedic surgeon will determine the appropriate treatment based on the type of fracture. Type I fractures typically require use of a splint or sling for several days, followed by an early, gradual increase in elbow and wrist movement, depending on the level of pain experienced. Type II fractures require use of a splint or sling for 1-2 weeks, followed by range-of-motion exercises.
For type I and type II fractures that are treated without surgery, axial loading activities should be avoided for the first 6 weeks after the injury. Axial loading activities involve pushing with the hand because this directs the force up through the forearm and into the elbow, putting pressure and force against the injured radial head. Examples of axial loading activities include: pushups, bench pressing weights, pushing heavy carts or objects, and using the hand to help push up, or stand up from a seated position.
Even the simplest of fractures may result in some loss of movement in the elbow. Depending on your fracture and treatment, your orthopaedic surgeon may recommend early movement to stretch and bend the elbow to help avoid stiffness. Discomfort, especially with certain movements, often lasts for months after a radial head fracture to the elbow, however, it should gradually fade with time.
Regardless of the type of fracture or the treatment used, exercises to restore movement and strength will be needed before resuming full activities.
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