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Which bones can be affected?
The elbow brings together the humerus, radius and ulna. The head of the radius is located near the joint and participates in the rotation of the forearm. The olecranon is the tip of the elbow, at the end of the ulna; the triceps tendon attaches to it to straighten the arm.
A fall can fracture one of these bones, but also damage ligaments or cause a dislocation. This guide mainly concerns fractures of the head of the radius and olecranon in adults. Childhood fractures and complex injuries require their own instructions. The word elbow fracture is not enough to determine an exercise program.
Understand the picture
Head of the radius and tip of the elbow
Radial head
It participates in the articulation and rotation of the forearm.
Olecranon
The tip of the ulna receives the attachment of the triceps.
Movement and load
Bending the arm and pushing on the hand do not impose the same constraints.
Symptoms and first assessment
A fracture can cause pain, swelling, bruising, and difficulty bending or straightening the elbow. Turning the palm can be painful, especially when the head of the radius is affected. Some barely displaced fractures still allow some movement. This does not exclude them.
After a fall with significant pain or limited use, seek a prompt assessment. The team also examines the skin, nerves and circulation to the fingers. Report pain associated with the wrist or shoulder: the same fall can affect several structures. Do not force extension to check if the elbow is broken or attempt to put a deformity back into place.
Emergencies and precautions in the meantime
A wound revealing the bone, a significant deformity, a cold or pale hand, new numbness or an inability to move the fingers is an emergency. Call 112 in Luxembourg if urgent help is needed. A loss of sensation after the trauma must be taken seriously even if the pain is not maximal.
Support the arm in the most comfortable position and avoid loading. Gently remove the jewelry if it is easy before the swelling increases. After placement of a cast or splint, the same circulatory and nerve symptoms require immediate reassessment. Increasing pain should not be simply masked while waiting for control.
X-ray, CT scan and stability
The x-rays show the fracture line, displacement and alignment. A CT scan can clarify a complex fracture. The examination also looks for instability or associated injurys. This information guides the choice between short immobilization, longer protection and intervention.
A small stable fracture of the head of the radius can allow relatively early mobilization according to instructions. A displaced fracture, dislocation or ligament repair may impose further limitations. Ask for the complete diagnosis, authorized movements and the date of the next check. Another elbow fracture patient's program is not a reliable model for your situation.
Radial head treatment
Treatment depends on the size of the fragments, their displacement and stability. Some fractures are treated without surgery, with protection and directed recovery of movements. Others require fixing the fragments or, in some situations, replacing the head of the radius.
Even in a form treated without surgery, loads and support can remain limited. Ask if forearm rotation is allowed and how to use a sling. Unnecessary prolonged immobilization may promote stiffness, but removing it alone may be unsuitable. The correct duration is decided with the team depending on the fracture and associated structures.
Chapter sources [1]
Olecranon Treatment
The tip of the elbow is close to the skin and receives traction from the triceps. A slightly displaced fracture can sometimes be protected without surgery. If the fragments are displaced or the extension mechanism is disrupted, surgical fixation may be necessary.
Restrictions include pushing with the arm, getting up from a chair or extending the elbow against resistance. These actions can place considerable strain on the repair even if they seem ordinary. After an operation, monitor the wound and avoid unauthorized direct pressure. The presence of equipment does not mean that bone healing is complete or that all exercises are permitted.
Chapter sources [2]
In everyday life
Prepare to resume a working day
List
Separate light tasks, carrying loads and pushing through the arm.
Check
Compare each task to the fracture restrictions.
Progress
Resume authorized tasks and then reassess strength, mobility and endurance.
Chapter sources [2]
Stiffness and the role of physiotherapy
The elbow can lose range of motion after a fracture, particularly in extension. The physiotherapist helps to resume authorized movements, control compensations and find useful movements. They work based on stability, fixing and protection instructions.
Brutally forcing a stiff joint does not automatically speed recovery and can irritate the tissues. The movement is built through regular practice adapted to the healing stage. Strengthening and support come when the team allows it. Our exercises section is not a post-fracture protocol: it can only serve as support if its movements have been validated for your case.
Wash, dress, sleep and work
Movements near the face require bending the elbow; turning a key or a handle also requires a rotation of the forearm. Describe these difficulties in choosing concrete goals. Clothing that is easy to put on and temporary help with certain tasks can make the first few weeks easier.
To sleep, support the arm without painful pressure on the elbow. Respect the splint if it must be worn at night. At work, discuss possible tasks: writing, carrying and pushing do not impose the same constraints. Driving only resumes when the instructions and your ability to control the vehicle allow it, taking into account medications.
Chapter sources [2]
Resumption of loads and sport
The progression goes from permitted movements to light tasks, then to greater efforts. Getting up by pushing on the armrests, carrying a suitcase or doing a push-up can place a high load on the elbow. Ask for concrete examples of what remains prohibited.
For sport, distinguish between general endurance, arm movements and the risk of falling or contact. A partial recovery can sometimes precede the complete recovery, but it must respect the bone healing. Increase one item at a time and watch the reaction. A sharp pain, blockage or new loss of movement requires advice, not more vigorous repetition.
Recovery and control
Bone healing takes several weeks and mobility may continue to improve for several months. A small extension limitation can persist without preventing all activities. The goal is useful function, taking into account the type of fracture and the demands of your life.
Keep appointments scheduled. Report increasing pain, redness or drainage from the wound, fever, new tingling, or loss of strength. Stiffness that no longer progresses also deserves a review with the team. Monitoring can adjust rehabilitation or look for a complication; it is not based solely on the number of weeks that have passed.
Your questions
Should I bend my elbow as soon as possible?
Early mobilization may be useful in some stable fractures, but it is not suitable for all repairs. Ask what movements are allowed and in what range. Your team's restrictions come before general stiffness advice.
Can I push on the armrest to get up?
This movement heavily loads the elbow and can strain the triceps or fixation. It may remain prohibited while light movements are permitted. Ask for specific instructions and use another strategy or aid as long as support is not permitted.
Chapter sources [2]
Will I get full extension again?
It depends on the fracture and progress over time. A limitation may persist, but the function may nevertheless become satisfactory. Rehabilitation targets useful movements without promising an exact angle. Unusual or blocked progress should be reviewed.
Is rehabilitation the same after a wrist fracture?
No. The structures, restrictions and movements to be found differ. A fracture of the olecranon, a fracture of the head of the radius and a fracture of the wrist require adapted programs. Do not transfer an exercise schedule from one region to another.
Sources and references
- [1] AAOS OrthoInfo: Radial head fractures
- [2] AAOS OrthoInfo: Olecranon fractures
- [3] NHS: Broken arm or wrist
- [4] CGDIS · Appeler le 112
Text updated on
Medical review: awaiting Hasib Selimovic.