These are relatively uncommon and are normally caused by trauma from a fall. Patients will hear or feel a snap or a crack in their elbow joint. The elbow will then become immediately painful, difficult to use and will swell rapidly. Any or all of the three main bones which make up the elbow joint (humerus, radius and ulna) can be involved in a fracture.
Treatment: Mild fractures can be treated non-operatively but more serious ones may require surgery.
This is chronic inflammation of the tendons on the outside of the elbow caused by overuse, typically in racquet sports. Patient will experience localised pain and weakness as well as difficulty holding or gripping objects.
Treatment: Most patients can be treated non-operatively with physiotherapy, forearm supports and, in some cases, injections. These can either be steroid injections or injections of platelets taken from their own blood. Shock wave therapy is also used and can speed up the recovery process. Only very rarely is surgery required.
Golfer’s elbow is chronic inflammation of the tendons attached on the inside of the elbow. The condition is caused by overuse or repetitive strain of the tendons.
Treatment: A careful history and examination is performed and the diagnosis confirmed by a clinical assessment and normally an ultrasound scan. Patients will normally settle with rest, physiotherapy, splints and occasional injections or shock wave therapy. Surgery is very rarely needed.
A loose body is when a loose piece of bone and/or cartilage becomes broken off from the articular surfaces inside the elbow joint. Patients experience intermittent episodes of acute pain associated with locking of their elbow joint. This will normally be traced back to an old injury. Alternatively, the elbow joint may have become arthritic and a minor traumatic event may cause part of that arthritic bone to break off. Patients with loose bodies in their joint complain of pain, clicking, locking and a sensation of instability preventing them enjoying their usual sports and activities.
Treatment: If symptoms are significant, keyhole surgery may be required to remove the loose bodies.
Elbow instability causes the joint to feel weak, loose, unstable and painful. There are various types of instability requiring careful clinical assessment and imaging.
Treatment: Non-operative treatment involves exercise-based strengthening, avoidance of aggravating factors and bracing to restrict movement. For more complex and severe cases, elbow ligament reconstruction surgery may be required.
Posterior Impingement of the Elbow
This is caused by overuse of the elbow joint and commonly affects people who play racquet sports, throw and box. Patients develop pain and tenderness at the back of the elbow when they attempt to straighten the joint. There may also be weakness and loss of power. For example, tennis players may notice their serving speed slows down.
Treatment: This condition is often treatable with physical therapy and steroid injections. If there is degenerative disease then Hyaluronic Acid Analogue injections may be required. In more severe cases, keyhole surgery may be performed.