Elbow Injuries: Insights on Ligament Damage and Recovery

Elbow issues

Hello, doctor.
I was in a car accident about five weeks ago, and I have two symptoms: a Colles' fracture in my left hand and a ligament injury in my right hand.
Today, I mainly want to ask about the condition of my right hand.
The accident occurred in another city, where I experienced multiple dislocations of my right elbow.
After being taken to the emergency room and having an X-ray, the doctor there suspected an injury to the lateral ligament.
However, when I returned to my hometown's medical center for treatment the next day, my attending physician diagnosed it as an injury to the medial ligament and also performed a CT scan.
Currently, my right hand's range of motion is quite good, but when I extend my arm with my palm facing down (pronation), I can only extend it to 150 degrees (I can extend it to 180 degrees with my palm facing up, and even when lying down, I can extend it to 180 degrees with my palm in pronation).
If I try to exert force to extend it further, the junction between the humerus and radius becomes prominent, causing discomfort and pain in that area.

I am puzzled because if the medial ligament is injured, why is the radius protruding? Could this protrusion be caused by the ligament injury? Will I need surgery? Note: My right hand has not yet received rehabilitation treatment.
I kindly ask for your clarification on this matter.
Recently, the focus of my treatment has been on the fracture in my left hand, and I have somewhat neglected my right hand.

Taiyang, 20~29 year old female. Ask Date: 2020/09/21

Dr. Wang Zhaomin reply Rehabilitation

Injury to the lateral ligaments of the wrist can indeed lead to limited joint mobility.
However, based on the description in your message, it is difficult to understand the true situation.
A physical examination on-site, along with relevant physical and clinical assessments, is necessary for further diagnosis.
Online consultations cannot replace an actual in-person visit.
Please consult with an orthopedic or rehabilitation specialist to discuss your condition and subsequent treatment plan.

Reply Date: 2020/09/21

More Info

Injuries to the elbow, particularly those involving ligament damage, can be complex and require careful evaluation and management. Based on your description, it seems that you have sustained a significant injury to your right elbow, which has involved multiple dislocations and potential ligament damage. The confusion regarding whether the injury is to the lateral or medial collateral ligaments is not uncommon, especially when multiple assessments yield different conclusions.
Firstly, the elbow joint is stabilized by several ligaments, including the medial (ulnar) collateral ligament and the lateral (radial) collateral ligament. Injuries to these ligaments can lead to instability, pain, and limited range of motion. The fact that you are experiencing pain and a limited range of motion when your palm is facing down (pronation) suggests that there may be some instability or damage to the ligaments that support the joint during this position.

The phenomenon you describe, where the radius appears to "float" or become prominent at the joint when you attempt to extend your arm, could indicate several things. It may suggest that there is a degree of instability in the joint, possibly due to ligamentous injury. When ligaments are damaged, they may not provide adequate support to the bones, leading to abnormal positioning or movement of the radius and humerus during certain motions. This could explain the pain and the floating sensation you are experiencing.

Regarding the need for surgery, this decision typically depends on several factors, including the degree of ligament damage, the stability of the elbow joint, and your functional needs. If the ligaments are partially torn and you are able to maintain a reasonable range of motion and function, conservative treatment, including physical therapy, may be sufficient. However, if there is significant instability or if conservative measures fail to improve your symptoms, surgical intervention may be necessary to repair the damaged ligaments.

It is also important to note that rehabilitation plays a crucial role in recovery from elbow injuries. Engaging in a structured rehabilitation program can help restore strength, flexibility, and function to the elbow. Physical therapy may include exercises to improve range of motion, strengthen the muscles around the elbow, and enhance overall joint stability. Since you mentioned that you have not yet started rehabilitation for your right hand, it would be advisable to consult with a physical therapist who can design a program tailored to your specific needs.

In summary, while the exact nature of your ligament injury and the need for surgery can only be determined through a thorough clinical evaluation, it is clear that your symptoms warrant further investigation and treatment. It is crucial to address both the immediate concerns regarding pain and mobility and to consider long-term rehabilitation to ensure optimal recovery. I recommend following up with an orthopedic specialist who can provide a comprehensive assessment and guide you through the appropriate treatment options for your elbow injury.

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