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How is a broken elbow treated?

Full arm cast with arm bent, stabilising a broken elbowThe way your broken olecranon is treated depends on many different factors, including:

If the break is unstable (the bone can move out of the right position) or the bone has shattered into many pieces, you may need surgery to put the broken bone back into the right place and hold it there until it heals.

If you have a stable (the bones don't move), less complex break you probably won't need surgery, but will need a cast to hold the bones in the right place while they heal. You will most likely wear the cast for six weeks before starting to gently move your arm again.

Sometimes a break seems to be stable and is put in a cast, but as the swelling goes down the broken bones move apart and need surgery to put them back in place. For this reason, you will have regular X-rays while your elbow is in a cast, to make sure the bones stay in the right place while they are healing.

Things you can do to help your healing

There are several things you can do yourself to help your olecranon heal, whether or not you are having surgery.

If you are not having surgery

Your arm will be put into a cast to hold the bones in place and stop them from moving. The cast will probably start near your wrist and go up your upper arm to near your armpit. Your arm will be bent, to help keep your elbow bones in the right place while they are healing.

You may need some time off work until the pain has settled (usually within a week). How much time you will need depends on what your job involves and if the arm you use the most (your dominant arm) is injured. Most office workers with an injury to their non-dominant arm can return to work after a week. Manual workers, or those who have injured their dominant arm, may need six to eight weeks off work.

You will wear the cast for six weeks, but can probably start doing some gentle hand exercises after three weeks and some gentle elbow exercises once the cast comes off. Your cast may be changed to a removable splint after three weeks so you can start gentle elbow exercises early.

You will still have to take special care of your elbow once the cast comes off.

Surgery for a broken olecranon

If you need surgery for your broken elbow it will be done by an orthopaedic (bone) surgeon.

Exactly what surgery you have will depend on what type of break you have. Your surgeon will talk to you about what it involves, the risks, benefits, and how you are likely to recover.

Your surgery will involve some metal (usually wires, or a plate and screws) to line up your bones properly and support them while they heal. It's possible the screws will be held together with clamps and rods outside your skin to stabilise the break. This is called external fixation.

You will probably spend one night in hospital, and your arm will be in a cast or backslab, which is a half-cast that wraps around the back of your arm, for up to four weeks.

Going home

broken elbow recoveryBefore you leave hospital a physiotherapist and occupational therapist will work out what help you may need at home and arrange it for you. You can also talk to a social worker about any worries you may have about going home. If you are older than 65, the Health Care of the Elderly team will review your health with the orthopaedic team.

When you leave hospital you will be given a follow-up appointment, a discharge letter and a prescription or medication card if you need one.

If you have any concerns after you go home, please see your GP.

Recovery after surgery

You most likely will need at least two weeks off work after surgery. Exactly how much time you will need depends on which bone was broken, whether the break was in the arm you use most (your dominant arm), what your job involves, and whether there are any light duties you can do. If you are an office worker you may need just 10 to 14 days off work. But if you are a manual worker you may need 10 or more weeks off.

As you recover you'll have regular appointments with your surgeon, and some X-rays to make sure your elbow is healing well. You may also need some physiotherapy to strengthen your hand and get it moving again.

Wires and external fixation usually need to be removed once you have healed. Exactly when that will happen depends on how bad your break was, and how quickly your bones heal.

For two to three months after surgery you will not be able to lift or carry anything with the affected hand. You should also avoid sport or any other activity that may make your injury worse. Your surgeon will let you know when it's safe to start doing these things again.

Written by HealthInfo clinical advisers. Endorsed by orthopaedic surgeon, Canterbury DHB. July 2017.

Sources

See also:

ACC help after an injury

Care of your cast

Living with an injury

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Review key: HIBRE-131977