Minos Ε. Tyllianakis MD, PhD

Fractures and fracture-dislocation of the elbow are serious injuries and involve distal humerus and proximal radius and ulna. In some cases, ligamentous injuries also occur. Conservative treatment is quite exceptional whilst surgical treatment requires a great deal of expertise because local anatomy is complex as bones and delicate neurovascular bundles are in close relation.

Special plates and screws are used for osteosynthesis. In fractures of the proximal radius replacement of the radial head (arthroplasty) may be necessary. Sometimes elbow arthroplasty is indicated in comminuted fractures in the elderly.

Even under ideal circumstances unfavorable results may be up to 30% with the major problem being postoperative stiffness of the elbow that may require long term physiotherapy or even surgery (arthrolysis). The patient is operated under general anaesthesia or axillary block. Active motion of the elbow starts after a couple of days and the patient is discharged after 5-7 days.

The most common postoperative complication is nerve dysfunction (radial, median, ulnar). Ectopic ossification (development of osseous tissue within muscles) that restricts motion can occur weeks after surgery and indicates further surgical intervention.