Though trauma and fractures around the elbow would be discussed in their relevant sections, I thought it would be better to get an overview when we are discussing elbow pain
Fractures
Elbow fractures are often easily diagnosed, as there usually is a history of a fall. The physical examination and radiographs confirm the diagnosis. The majority of elbow fractures can be treated without surgery.
Most simple fractures heal without consequence. Complications such as malunions and nonunions may lead to joint stiffness and pain. Surgery usually is required for displaced fractures.
Ligament Injuries
The elbow has two primary ligamentous constraints the medial collateral and lateral collateral ligament is the primary elbow stabilizer. These ligaments may be injured from a fall or repetitive stress injury (e.g., a baseball pitcher).
Physical examination reveals tenderness directly overlying the ligament, possibly with sort-tissue swelling. If the ligament is stretched or torn, there may be laxity with stress testing.
Treatment for simple sprains consists of rest, bracing, icing, NSAIDs and physical therapy. Completely torn ligaments may require surgical reconstruction.
Biceps-Tendon Injuries
The insertion of the biceps tendon on the proximal radius may be injured lifting very heavy objects (e.g., a large television set). Physical examination reveals tenderness to palpation with simple strains, and the absence of a palpable tendon in complete tears.
Radiographs are normal. MRI is infrequently required to confirm the diagnosis. Treatment of strains is conservative; complete tears often require surgical repair for optimum function.
Osteochondritis Dessicans
This condition often is seen in athletes who throw (i.e., pitcher, quarterback, shot-putter) and is characterized by dull, achy elbow pain. Physical examination may reveal limited range of motion but often is benign.
Radiographs depict a bony lesion most commonly affecting the capitellum. Computed tomography provides better detail and may be needed for diagnosis. Those patients who do not respond to conservative modalities may benefit from arthroscopic debridement.
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