
Is There a Loose Fragment in Your Elbow?

Your elbow is a complicated joint made up of three bones held together by ligaments, muscles, cartilage, and tendons. Occasionally, small pieces of bone or cartilage can break off and move around in the joint.
While the condition can occur without initial symptoms, long-term consequences can include limited elbow function and arthritis. Pain may become continuous and accompanied by other symptoms that affect daily activities and normal movement of the joint.
The signs and symptoms of having a loose fragment — also called a loose body — in your elbow are often similar to other types of joint injuries. Therefore, the condition requires a professional examination for an accurate diagnosis and treatment.
At Metairie Orthopedics & Sports Medicine in Metairie, Louisiana, orthopedic surgeon Robert Douglas Bostick III, MD, provides expert treatment for patients who have a loose fragment in their elbow. In this blog, he explains why the condition can occur and how it can be treated.
How an elbow can get a loose fragment
A common reason an elbow can get a loose fragment is because of a condition called osteochondritis dissecans. This is a condition in which a piece of bone in the joint loses its blood supply and separates from the rest of the bone. The piece of bone and the cartilage covering it can then crack and loosen.
Another common reason an elbow can get a loose fragment is due to osteoarthritis. Osteoarthritis is a degenerative bone disease in which the cartilage wears down over time.
An elbow can also get a loose fragment due to elbow injuries, such as elbow dislocations or fractures. Furthermore, individuals who participate in stressful sports, overhead activities, or manual work have a higher risk of developing this condition.
Symptoms of a loose fragment in your elbow
Elbow pain triggered by physical activity is the most common symptom of a loose fragment in your elbow. While this type of pain can occur with many elbow problems, the following symptoms are often specific to this condition:
- Swelling and tenderness of the skin around your elbow
- Difficulty straightening your elbow joint completely
- Popping of the elbow joint
- An elbow joint that is stuck in one position
- A sensation that feels like your elbow joint is weakening or giving way
While these symptoms may not occur initially, they can develop over time if the fragment loosens and gets caught between two parts of your elbow joint. This can occur as the joint fragment floats in the joint fluid. The fragment will likely continue to grow as it floats, because it will be maintained by the nutrients in the joint fluid.
Treating a loose fragment in your elbow
If you have a loose fragment in your elbow, conservative care or surgical treatment may help you get well.
Conservative measures
If symptoms don’t improve after a reasonable amount of time, splinting or casting the affected arm may help isolate the joint to allow for a course of proper rest.
Immobilizing the affected area and resting for 2-4 months can often be effective in treating children and young teens who develop this condition. For some patients, physical therapy to strengthen the joint and improve movement may be recommended.
Surgical intervention
Any of the following conditions may indicate the need for surgical intervention to achieve relief from a loose fragment in your elbow:
- Pain that fails to improve with conservative treatment
- A bone fragment that is lodged in your elbow joint
- A bone fragment that floats around in your elbow joint
- A bone fragment that is larger than 1 centimeter in adults or older teens
The most common treatment for a loose fragment in the elbow is minimally invasive arthroscopic surgery. During this procedure, Dr. Bostick makes tiny holes in your elbow and uses long, thin surgical instruments to locate and extract the loose fragment through these small entry points.
A tiny camera inserted through one of the holes projects pictures on a television monitor to guide Dr. Bostick in locating and removing the debris. A rehabilitation program is usually required to restore strength and range of motion after the procedure.
If you have elbow pain, getting an accurate diagnosis is the first step in achieving relief. To learn more, book an appointment online or over the phone with Metairie Orthopedics & Sports Medicine today.
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