23 October, 2018
Messi’s elbow injury: what it could be and why he is not being operated on
In light of Lionel Messi’s elbow injury last weekend, a lot of people are asking me about it. According to the official report from the FC. Barcelona Medical Department: “Tests carried out on the first-team player, Leo Messi, have confirmed that he has a fracture of the radius bone in his right arm. He will be out of action for approximately three weeks”. Without being in possession of all the information on the case, I will try to explain what Messi’s elbow injury consists of, and in which cases surgery may not be necessary.
HOW DOES THE ELBOW WORK?
First I’m going to explain, in simple terms, how the elbow works. It is made up of 3 bones: in the upper section we find the humerus, which has 2 parts (one joint for the ulna and another for the radius) and in the lower section, it comprises 2 bones: the radius (radial head) and the ulna (olecranon). The elbow has a double movement: the ability to flex and extend (owing, above all, to the humerus-olecranon part) and the ability to turn the palm of the hand upwards and downwards, called pronation and supination (owing, principally, to the movement of the radial head-humerus). Thus, the 3 bones in the elbow allow us to flex/extend the arm and to turn the hand upwards and downwards.
“The set of 3 bones in the elbow (humerus, radius and ulna) allow us to flex/extend the arm and to turn the hand upwards and downwards.”
MESSI’S ELBOW INJURY: FRACTURE WITHOUT DISLOCATION
After examining footage of the match, as I supposed at the time of the injury and as I communicated via social networks, we can confirm that Leo does NOT have a dislocated elbow (a much more serious injury, when the elbow joint “comes out of place” and the ligaments are torn).
According to information we have, and without being able to see the results of the imaging tests, we can presuppose 2 scenarios:
Stable fracture with damage to the elbow ligaments.
It could be a simple isolated fracture, referred to as stable, not far from the radial head and with no damage to the elbow ligaments. In this case, no surgical treatment is recommended and the best option is initial immobilisation and starting early physiotherapy to prevent rigidity in the elbow. In cases of prolonged immobilisation, rigidity is more frequent in the elbow than other joints. If it is a fracture of this type, he could be back in action within 3 to 5 weeks, although we should bear in mind that we need to allow at least 6 weeks to be able to consider that the fractured bone has “fused”.
“If it is a stable fracture with no ligament damage, he could be back in action within 3 to 5 weeks, although 6 weeks need to be allowed for the fractured bone to ‘fuse’”
Unstable comminuted fracture
It could be an unstable comminuted fracture (in various pieces) for which surgical synthesis (putting all the fragments back in their place) is very difficult. In such cases, it may be advisable to immobilise the limb and allow the fracture to heal not “entirely correctly” and hope that this does not lead to any instability in the elbow. If there is no ligament damage, it is less likely to be unstable. In the case of a fracture of this type, it would be essential to start physiotherapy early to prevent any rigidity, but also the recovery period would be longer, since a new fall could entail the early displacement of the fracture.
“In the case of an unstable comminuted fracture, it would be essential to start physiotherapy early to prevent any rigidity, but the recovery period would also be longer”
We should remember that the treatments proposed for elite athletes are not always the best for patients. At times, early recovery is preferred, at the risk of increasing the after-effects in the medium to long term.
Let’s hope that Messi’s elbow injury is a stable fracture with no ligament damage, as the prognosis and recovery periods are much better, and the after-effects practically non-existent. We will have to see how the injury progresses and we wish him a speedy and complete recovery.
“Let’s hope that Messi’s elbow injury is a stable fracture with no ligament damage. The prognosis and recovery times are better, and the after-affects virtually non-existent”