Medication Summary

The medications used in the management of elbow fractures include analgesics, either oral or parenteral. In addition, oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may confer some protection against the formation of heterotopic ossification. Conscious sedation may be required for the initial closed reduction of a fracture. Intravenous sedative and narcotic agents are commonly used to perform conscious sedation.

Class Summary

Adequate analgesia is an important aspect of patient care. For mild to moderate pain, oral anti-inflammatory/analgesic medications are used. Parenteral analgesia is usually required for patients with severe pain.

Ibuprofen (Motrin, Ibuprin)

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DOC for mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Oxycodone and acetaminophen (Roxicet, Percocet, Roxilox, Tylox)

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Drug combination for moderate to severe pain.

Morphine sulfate (Astramorph, Duramorph, MS Contin, MSIR)

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DOC for analgesia because of reliable and predictable effects, safety profile, and ease of reversibility with naloxone.

Various IV doses are used; commonly titrated until desired effect obtained.

Class Summary

Act in the spinal cord to induce muscle relaxation. Can provide proper sedation in order to achieve closed reduction of a fracture. Sedatives work synergistically with parenteral narcotic medications.

Midazolam (Versed)

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Shorter-acting benzodiazepine sedative-hypnotic useful in patients requiring acute and/or short-term sedation. Also useful for its amnestic effects.

Follow-up

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Media Gallery

Milch classification of condylar fractures.
Medial epicondylar fracture

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Author

John D Kelly, IV, MD Associate Professor, Department of Orthopedic Surgery, University of Pennsylvania, Attending Surgeon Pennsylvania Hospital, Veterans Adminsitration Hospital

John D Kelly, IV, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Eastern Orthopaedic Association, Pennsylvania Orthopaedic Society, Philadelphia County Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

David Wald, DO, FACOEP Assistant Program Director, Assistant Professor, Department of Medicine, Division of Emergency Medicine, Temple University School of Medicine

David Wald, DO, FACOEP is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Henry T Goitz, MD Clinical Professor of Orthopaedic Surgery and Sports Medicine, Michigan State University College of Human Medicine; Academic Chief of Orthopaedic Sports Medicine, Regional Director of Ambulatory Clinic Site, Sports Medicine Institute, Detroit Medical Center

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Detroit Academy of Orthopaedic Surgeons, International Association for Dance Medicine and Science, International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, Michigan Orthopaedic Society, Michigan State Medical Society, Mid-America Orthopaedic Association

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Leslie Milne, MD Assistant Clinical Instructor, Department of Emergency Medicine, Harvard University School of Medicine

Leslie Milne, MD is a member of the following medical societies: American College of Sports Medicine

Disclosure: Nothing to disclose.