Elvis Andrus' Fractured ELbOW
In the 9th inning of yesterday's game against the Angels, Elvis Andrus sustained an elbow fracture. The injury occurred with a direct impact of a 97 MPH fastball to the tip of the elbow. The injury was furthered evaluated after the game and x-ray confirmed a fractured elbow that does not require surgery. Based on early reports and the point of impact to the elbow elbow, he has sustained an olecranon fracture of the elbow. Olecranon fractures routinely are associated with other fractures of the elbow that include a radial head or radial neck fracture to name a few, however that has not been reported.
Elbow Fracture Insights
Based on the mechanism of a direct impact to the elbow the most likely injury is called an olecranon fracture. The olecranon is the point of the elbow, which is part of the ulna bone where the triceps attaches. There is not significant soft tissue between the skin and the bone so it is vulnerable to injury when it hits a hard surface or struck by a hard object. The determination of surgery depends on the displacement of the fracture and if the fracture includes the joint surface. In this case, if it is an olecranon fracture it possibly is displaced at the joint surface necessitating surgery (see photo above). Early reports state no surgery is needed so there is likely no gap at the joint surface. When the fracture is non-surgical usually an above elbow cast or splint for 4-6 weeks is the appropriate treatment. Usually with a return to play at 6-8 weeks. For completeness, when this type of fracture requires surgery a few possibilities come to mind. Options include aligning the fracture fragments and using a tension wire, screw fixation or locking plate to stabilize the fracture. Typically, immobilization will still be needed but the benefit is that it can be done for a shorter period of time allowing for early mobilization and less stiffness or risk of loss of range of motion. Physical therapy is often needed after an elbow fracture, in order to regain full range of motion and strength.