The following is a transcript of an interview with Dr. Bennett:
Elbows are a hinge joint with four planes of motion — flexion, extension, supination, and pronation. Injuries generally have to do with the cartilage or the ligaments that stabilize the elbow. You can have chronic problems or you can have acute problems. The acute problems are those traumatic injuries that occur, like if someone falls and they land on their outstretched hand or elbow and they can develop a fracture that can occur after a fall. A fracture is a broken bone, and it can happen anywhere in the elbow. It can happen in the radial head, or it can happen in the olecranon or it can happen at the distal humerus. How much displacement that fracture shows or where that fracture is determines your method of treatment. Sometimes it can be treated with a cast or a splint and sometimes it needs surgical intervention. It all depends on the fracture itself and the amount of displacement and the activity of the patient.
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| Left elbow-joint Left: anterior and ulnar collateral ligaments Right: posterior and radial collateral ligaments (Photo credit: Wikipedia) |
Another acute injury is tendon or ligament injury. Sometimes you can fall on your outstretched hand and you can dislocate your elbow where the elbow pops out of the joint and that tears the majority of the ligaments that stabilize the elbow as well as the surrounding capsule of the elbow. The immediate method of treatment for the dislocation is reducing the elbow and popping it back into place. If you don’t reduce the elbow, the patient can become a chronic problem and you can have some vascular issues or blood vessel injuries. So you want to make sure you get the elbow immediately reduced and lots of times these dislocations, if they’re just dislocations, can be treated with just bracing and letting it heal. Many times the ligaments will actually scar back into place and the elbow joint will tighten and stabilize again over time. That’s an elbow dislocation.
Now in addition to that, you can have acute traumatic tears in any of the ligaments surrounding the elbow. Dislocation is when all the ligaments are torn, but you can also have a traumatic tear of the lateral ligament, outside of the elbow, or medial ligament, inside of the elbow, or anterior ligament, which is the front of the elbow or posterior ligament, which is the back of the elbow.
Now if you have a tear of the tendon in the front of the elbow, that’s the biceps tendon. That allows you to flex the elbow and gives you the big muscles that people like to show off at the beach, that’s the biceps tendon. That actually contributes a lot of strength to elbow flexion as well as elbow rotation. If you’re an active young person and you have a tear in the biceps, we usually recommend fixing those early because they get harder to fix, the longer you wait. And if you don’t fix them, you have to understand that you could lose up to 80% of your rotation strength by not fixing that distal biceps tendon.
Regarding the posterior aspect of the elbow which is the back of the elbow, the tendon in the back of the elbow is the triceps tendon which gives you strength with extension of the elbow and it’s very important for doing things like push ups or blocking people in football or just lifting weights above your head the triceps is very important so if you have a full rupture of the triceps or a tear of the triceps then you lose significant strength with extension, which is very important with any of those activities. So usually in that case, we recommend fixing the triceps and we usually want to fix it early as opposed to later because the longer you wait, the more retracted the tendon will be and the harder it’s going to be to fix. You can have tendonitis, you can have a partial tear of the triceps and a lot of times those can be treated non-operatively, but when you have a full tear, you typically want to fix it.
Other areas that can be torn with an acute trauma situation are the medial or lateral collateral ligaments of the elbow, which stabilize the elbow on the inside and the outside of the elbow joint and the medial collateral ligament, which is also the ulnar collateral ligament is the main ligament that stabilizes the elbow when you throw. Every time you throw a ball or pitch a ball that ligament will undergo a significant amount of stress. And occasionally, you can tear or rupture that ligament with those types of activities. If you have a job or a position or play a sport that requires you to do a lot of throwing, then a completely torn ligament needs to be fixed. Now sometimes you can have a partial tear of that ligament, and with a partial tear you can be rehabilitated and the elbow can be braced and let that ligament heal and let it scar. But if it’s a complete tear, a lot of times that ligament will not heal in its normal position and it’s better to fix it. You can have the same thing with the lateral side, which is the outside of the elbow, which can cause instability on the outside of the elbow, which is important if you’re doing push ups or pull ups or any kind forced extension of the elbow, it becomes very important to stabilize the elbow, and if that’s torn, typically if you’re active and you’re young and you’re symptomatic, you have pain and instability, then typically we recommend to fix that as well and it’s always easier to fix these ligament tears earlier as opposed to later. This sums up the traumatic, acute injuries of the elbow.
If you’re dealing with an acute elbow injury you’re looking for an Elbow Doctor in Sugar Land, Katy, Missouri City or Houston, please call us at 281-633-8600 for an evaluation. Please share this information with your friends by using the social media buttons below. If you have questions, please call 281-633-8600 for an appointment.
