How Long Does a Fractured Elbow Take to Heal? Surgery & Recovery

An elbow fracture occurs when one or more of the three bones in the elbow (radius, ulna, and humerus) are broken. Elbow fractures can also cause injury to the muscles, ligaments, nerves, and blood vessels that surround the bones, requiring immediate medical attention.

Types of elbow fractures include:

• Nondisplaced: Bone has cracked or broken but stayed in place
• Displaced: Two ends of the broken bone shifted from their original position
• Comminuted: Bone has cracked or broken into many pieces
• Open: Broken bone went through the skin

Elbow fractures can range in severity and are divided into categories I to III:

• Type I: Bone is fractured but still in its normal position
• Type II: A piece or part of the bone has fractured and shifted from its normal position
• Type III: There are multiple fractures in the bone

Type I and II fractures are typically treated without surgery; however, type III fractures are usually treated surgically. 

Because the bony tip of the elbow is fragile and lacks adequate soft tissue protection, elbows can shatter in a number of ways depending on the nature of the damage. Common elbow fractures include

• Olecranon fracture: The olecranon is a protruding bony portion of the elbow.  This bony surface can be broken by a fall or another direct force on the region.
• Fractured radial head: The elbow joint is made up of three bones: the upper arm bone (humerus) and two forearm bones (ulna and radius). The head of the radius bone is broken in this type of fracture.
• Supracondylar fracture: This type of fracture affects the base of the upper arm bone and is more common in children. It frequently results in bone displacement.

Pain, swelling, bruising, and inability to move the elbow are signs of a fractured elbow. If the fracture is displaced or a joint is dislocated, a limb deformity may occur. 

Depending on the cause and severity, signs of a fractured elbow may include:

• Sharp, intense pain
• Redness and tenderness around the site of injury
• Swelling along the elbow or forearm
• Difficulty moving the elbow or forearm
• Popping or snapping sound at the time of injury
• Stiffness in the elbow joint
• Bruising along the elbow or forearm
• Pale, numbness, and tingling in the arm, wrist, or hand
• General instability in the elbow joint
• Visibly dislocated bone 

If you have these symptoms, seek medical attention to avoid further complications. Depending on your symptoms, several tests may be ordered. 

An X-ray shows pictures of bone structures that can be used to diagnose elbow fractures. Your doctor may also request an MRI to visualize soft tissue damage or a CT scan for better bone examination.

The elbow is very sensitive to damage due to repetitive use, and fractures can occur as a result of significant impact or excessive pressure applied to the bone.

Direct impact

• Car crash
• Landing awkwardly from a fall
• Catching something heavy

Repetitive force

• Overuse
• Pushing repeatedly
• Physical stress

Indirect impact

• Referred shockwave from impact to the wrist, hand, or shoulder

Possible causes

• Fall on the elbow
• Direct blow to the elbow
• Twisting injury to the arm
• Fall on an outstretched arm with the elbow locked in extension
• Trauma due to events such as automobile or bike accidents

Risk factors for an elbow fracture may include:

• Age (children and the elderly are more prone to fractures)
• Participation in sports (such as football, gymnastics, bicycling, or skateboarding)
• Osteoporosis
• Postmenopause
• Bone tumors or cysts
• Decreased muscle mass

While you may not be able to completely avoid injury, you can take preventative measures to reduce the risk of suffering an elbow fracture:

• Use well-fitted safety equipment during sports or physical activity
• Learn proper techniques and form for exercises
• Maintain overall fitness 
• Warm up before athletic activities

Treatment options for a fractured elbow vary according to the following factors:

• Severity and type of fracture
• Location of the fracture
• Damage to the nerves and blood vessels
• Age and general health

Your doctor will determine the right course of treatment depending on your individual case. You must refrain from lifting anything with the damaged arm for at least 6 weeks following the injury. 

Conservative treatment

• For the first 1-2 days, your doctor may recommend applying an ice pack to the affected area every 3-4 hours for up to 20 minutes at a time.
• The arm should be supported or elevated with the help of pillows.
• Pain relievers or nonsteroidal anti-inflammatory drugs, such as ibuprofen, may be used to relieve pain and reduce swelling.

Nonsurgical treatment

• Elbow fractures must be stabilized to prevent any further damage. Therefore, the first step is for the doctor to realign the bones before applying a splint or cast. 
• If the fracture is stable and there is no displacement, the doctor may apply a splint or cast to keep the bones aligned while healing.
• Unlike casts, splints provide less support. However, it is easy to adjust them to accommodate swelling

Surgical treatment

If bone pieces are displaced, surgery is required to ensure that the fracture heals properly. 

• Closed reduction and percutaneous pinning
  • Displaced bone pieces are repositioned and kept in place with metal pins.
  • The pins are inserted through the skin, into the bone, and across the fracture.
  • The damaged area is covered with a splint or cast for the first week. 
  • A few weeks after the surgery, the surgeon will remove the pins and splint/cast.
• Open reduction and internal fixation
  • This type of surgery is required for fractures that cannot be moved during a closed reduction or cause nerve or vascular injury.
  • Open fractures are scheduled for emergency surgery to reduce infection risk. People with this type of fracture will be administered antibiotics.

Rehabilitation after surgery

• Getting your elbow moving after surgery is an important part of recovery since the biggest concern after elbow surgery is stiffness. 
• Physical therapy should begin as soon as permitted by your doctor and can help you regain range of motion and strength in the injured arm. 
• Strengthening exercises, scar massage, ultrasound therapy, heat therapy, and ice therapy may all be recommended.

Untreated elbow fractures can lead to severe pain and disability. Common complications may include:

• Stiffness: It is common for the joint to become stiff after an elbow fracture or after elbow surgery. Your shoulder, hand, and wrist will often compensate for the loss of movement.
• Heterotopic ossification (HO): HO is the growth of a new bone in the soft tissues, which occurs rarely following a fracture or surgery. This can cause joint stiffness, and because it creates a mechanical block to mobility, surgery to remove the new bone development may be needed.
• Arthritis: There is a risk of post-traumatic arthritis of the joint if a fracture affects a joint (intra-articular). Elbow arthritis can begin immediately after a fracture or develop many years later when the joint surfaces wear away over time.
• Other complications:
  • Injury to the growth plate, which can lead to early closure
  • Damage to the nerves and blood vessels around the elbow
  • Restriction of movement of the elbow joint
  • Infection around pins placed into the elbow

Because the elbow is such a complex joint, the prognosis for a fractured elbow depends on several factors, including age, overall health, and severity of the injury. 

If there are no complications during the healing process, most people will make a complete recovery, especially with proper treatment.