How to tell a broken bone from a hole in the snow

Winter is definitely here, with snow and ice in the morning, followed by sun and puddles in the afternoon. This can often cause a fall. Falling forward is a very common injury from many outside activities -- including skiing, snowboarding or running on icy trails -- and usually results in nothing more than a bruise or a bump.

Most commonly, falls mean a fracture of the wrist or hand, but sometimes the force of the blow can be transferred up the arm to the elbow. In this case, there could be a fracture or dislocation of the bones of the elbow, and the radial head is often where this occurs.

There are two bones in the forearm that connect to one in the upper arm. The humerus is the bone that goes from the shoulder to the elbow. At the elbow, it widens out so that it can connect to the bones of the forearm (the radius and the ulna). The construction of the forearm is complex in that it must allow rotation of the forearm so the wrist can go from facing down to facing up while still providing stability. This is achieved by having each bone swap functions at each end of the forearm. In the elbow, the radius is the bone that rotates. In the wrist, the ulna is the one that allows rotation. It is a pretty neat construct.

If there are excess loads to the forearm or wrist, these stresses can literally be sent up the arm to the elbow. This can result in so much force on the elbow and the forearm bones that something has to give. What gives depends upon many things, but one of the most important is that age of the person.

Young children tend to dislocate the elbow or fracture the end of the humerus or upper arm bone. Older people tend to fracture the wrist since they tend to have less calcium and weaker bones. Between the ages of 30 and 40, more commonly in women, the part of the radius bone that connects with the elbow is where the fracture occurs.

If you are unlucky enough to have an injury like this, here are some of the signs that you should look for:

Pain in and around the elbow, especially on the outside of the elbow.

Swelling around the elbow, especially on the outside.

Pain with bending or straightening the elbow.

Pain with trying to turn the forearm, such as with turning the palm up and down.

Pain in the elbow, especially on the outside, when gripping.

If any of these symptoms are present, you should get the arm in a sling or a splint to protect it and get it checked out. In most cases, the diagnosis is made from a routine X-ray, and we can classify the break as either a type I, II or III fracture depending on the severity.

If the initial X-rays are negative and the pain and especially loss of motion persist, you might need an MRI. This will allow proper treatment and hopefully a rapid return to full activity.

Paul Collins, M.D., is an orthopedic surgeon specializing in sports medicine at Orthopedic Health Care in Boise, Idaho. Collins is an avid participant in many outdoor activities.

Source: http://dailycamera.com/news/2007/dec/20/the-elbow-fractures-connected-to-the/