Elbow Fractures
Elbow fractures range from minor radial head chips that can be treated non-operatively to complex distal humerus fractures requiring reconstructive surgery. At Maryland Orthopedic Specialists, our fellowship-trained surgeons manage the full spectrum of elbow fractures — from isolated injuries in weekend athletes to high-energy periarticular fractures in trauma patients — with the goal of restoring a pain-free, functional arc of motion. Early, accurate diagnosis and the right treatment pathway make the difference between a complete recovery and a stiff, painful elbow.
Ready to get started?
Schedule an appointment with a specialist experienced in treating elbow fractures.
In-network with most major insurance plans. Same-day appointments available for acute injuries.
What is elbow fractures?
Three fracture patterns account for the majority of elbow fractures seen in clinical practice: ### Radial Head Fractures The radial head is the most commonly fractured bone about the elbow. Injury typically results from a fall on an outstretched hand, transmitting axial load through the forearm.
Three fracture patterns account for the majority of elbow fractures seen in clinical practice:
Radial Head Fractures
The radial head is the most commonly fractured bone about the elbow. Injury typically results from a fall on an outstretched hand, transmitting axial load through the forearm. The Mason classification guides management:
- Mason I — Non-displaced or minimally displaced (<2 mm); treated non-operatively with early mobilization.
- Mason II — Displaced or angulated single-fragment fracture; operative fixation considered if the fragment blocks forearm rotation.
- Mason III — Comminuted radial head fracture; radial head excision or radial head replacement (metallic prosthesis) is preferred when open reduction and internal fixation (ORIF) is not feasible.
- Mason IV — Any radial head fracture associated with elbow dislocation.
When a radial head fracture co-exists with elbow dislocation and coronoid fracture, the injury is termed the "terrible triad" — a highly unstable pattern requiring systematic surgical repair of all three structures to restore elbow stability.
Olecranon Fractures
The olecranon is subject to avulsion injury from triceps pull or direct trauma. The proximal ulna's subcutaneous position makes it vulnerable. Undisplaced fractures can be splinted, but most displaced olecranon fractures are treated with tension-band wiring or plate-and-screw ORIF to restore the extensor mechanism and allow early motion.
Distal Humerus Fractures
Bicolumnar fractures of the distal humerus are among the most technically demanding injuries in orthopedics. Standard treatment for active patients is ORIF with dual-column plating (orthogonal or parallel plate constructs), which allows early rehabilitation. In elderly patients with severe osteoporosis or comminuted articular damage — particularly those with pre-existing elbow arthritis — total elbow arthroplasty (TEA) achieves more predictable functional outcomes than ORIF and has been shown to provide superior early range of motion and lower re-operation rates in randomized trials.
Treatment options
Non-Operative
Non-displaced Radial head fractures: sling for 5–7 days, then active range-of-motion (ROM) exercises. Undisplaced olecranon fractures: posterior splint for 3 weeks followed by progressive ROM. Non-displaced distal humerus fractures in very low-demand patients.
Operative
Technique depends on fracture location, amount of comminution/fragmentation, and surgeon preference.
Frequently Asked Questions
Will I need surgery for a broken elbow?
What is a "terrible triad" injury?
What is radial head replacement?
When is total elbow arthroplasty appropriate?
How long until I can drive after elbow surgery?
Meet the specialists
Related conditions
References
- Guitton TG, Ring D; Science of Variation Group. Interobserver reliability of radial head fracture classification systems. Journal of Bone and Joint Surgery (JBJS). 2011;93(9):e47. https://doi.org/10.2106/JBJS.J.01292
- McKee MD, Veillette CJ, Hall JA, et al. A multicenter, prospective, randomized, controlled trial of open reduction–internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients. Journal of Shoulder and Elbow Surgery (JSES). 2009;18(1):3–12. https://doi.org/10.1016/j.jse.2008.06.005
- Pugh DM, Wild LM, Schemitsch EH, King GJ, McKee MD. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Journal of Bone and Joint Surgery (JBJS). 2004;86(6):1122–1130. https://doi.org/10.2106/00004623-200406000-00002
- American Academy of Orthopaedic Surgeons. Elbow Fractures — OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/elbow-fractures (accessed May 2026).
- Sanchez-Sotelo J, Torchia ME, O'Driscoll SW. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique. Journal of Bone and Joint Surgery (JBJS). 2007;89(5):961–969. https://doi.org/10.2106/JBJS.E.01311