Internal Elbow Brace vs. External Elbow Brace: A Comparison

on May 19, 2024

The evolution of medical technology has significantly impacted the treatment of elbow injuries, particularly those involving the ulnar collateral ligament (UCL). Among the various treatment options, the use of internal and external elbow braces has become a focal point. This blog post delves into the nuances of internal versus external elbow braces, providing a comprehensive comparison to help patients, athletes, and healthcare professionals make informed decisions.


Introduction to Elbow Bracing

Elbow braces are designed to provide support, stability, and protection to the elbow joint, especially during the recovery phase of an injury. The primary types of elbow braces include internal braces, which are surgically implanted, and external braces, which are worn externally. Each type has its unique applications, benefits, and drawbacks.


Anatomy of the Elbow and Common Injuries

Understanding the basic anatomy of the elbow is essential to grasp the mechanics of bracing. The elbow joint consists of three bones: the humerus, radius, and ulna. The UCL, located on the inner side of the elbow, is a key ligament that provides stability, particularly in throwing motions. Common injuries include UCL tears, tendonitis, and fractures.


Internal Elbow Braces

Definition and Purpose:
Internal elbow braces, also known as internal fixation devices, are surgically implanted to provide structural support from within the body. They are often used in cases of severe UCL injuries or fractures.

Surgical Procedure:
The procedure involves the implantation of a synthetic brace or anchor within the elbow. This is typically done through minimally invasive surgery. The internal brace supports the ligament or bone as it heals, allowing for a more stable and natural recovery process.

- Enhanced Stability:
Internal braces provide superior stability compared to external options, as they are directly attached to the bone or ligament.
- Natural Movement: They allow for a more natural range of motion, which is crucial for athletes, especially pitchers and throwers.
- Reduced Recovery Time: Some studies suggest that internal braces can shorten recovery time and reduce the risk of re-injury.


- Invasive Procedure: The need for surgery can be a significant drawback, involving risks such as infection, complications from anesthesia, and longer initial recovery periods.
- Cost: Surgical procedures and implants can be expensive, making them less accessible for some patients.


External Elbow Braces

Definition and Purpose:
External elbow braces are devices worn outside the body to support and stabilize the elbow joint. They are commonly used in the treatment of mild to moderate injuries and during the rehabilitation phase post-surgery.

Types of External Braces:
- Hinged Braces:
These provide controlled movement and are often used post-surgery to protect the joint during healing.
- Compression Sleeves: Used to reduce swelling and provide mild support.
- Functional Braces: Designed for use during activities to prevent injury and provide support.


- Non-Invasive: External braces do not require surgery, eliminating the risks associated with surgical procedures.
- Adjustable and Removable: They can be adjusted for comfort and removed as needed, allowing for easy hygiene and flexibility in treatment.
- Cost-Effective: Generally, external braces are more affordable than internal braces and do not involve surgical costs.


- Limited Stability: Compared to internal braces, external braces may not provide the same level of stability, particularly in high-stress activities.
- Comfort Issues: Wearing an external brace can sometimes be uncomfortable, especially during prolonged use or intense physical activity.


Clinical Outcomes and Studies

Internal Braces:
Research indicates that internal braces can be highly effective in treating UCL injuries, particularly in athletes. A study published in the American Journal of Sports Medicine found that athletes who underwent UCL repair with an internal brace had a higher rate of return to play and a shorter recovery time compared to traditional UCL reconstruction.

External Braces:
External braces have shown positive outcomes in the management of mild to moderate elbow injuries. A study in the Journal of Orthopaedic & Sports Physical Therapy demonstrated that patients using hinged external braces post-surgery had improved joint stability and reduced pain levels during the recovery phase.


Case Studies and Testimonials

Athlete Success Stories:
Numerous professional athletes have successfully returned to their sports after using internal braces. For instance, Spencer Strider of the Atlanta Braves underwent UCL repair with an internal brace and is expected to make a full recovery. Similarly, Drew Rasmussen of the Tampa Bay Rays chose internal bracing to expedite his return to the field.

Patient Experiences with External Braces:
Many patients have reported positive experiences with external braces, particularly for managing chronic conditions like tendonitis. Testimonials often highlight the comfort and ease of use of modern external braces, as well as their effectiveness in reducing pain and improving function.


Choosing the Right Brace: Factors to Consider

Severity of Injury:
The extent of the injury is a primary factor in deciding between internal and external bracing. Severe injuries or complete UCL tears may necessitate internal bracing, while milder injuries can often be managed with external braces.

Activity Level:
Athletes or individuals with high activity levels may benefit more from the stability and support provided by internal braces. In contrast, those with lower activity demands might find external braces sufficient.

Recovery Goals:
The desired speed and extent of recovery can influence the choice. Internal braces may offer a quicker return to high-performance activities, whereas external braces are suitable for gradual recovery and long-term management.

Cost and Accessibility:
Financial considerations and access to surgical facilities also play a crucial role. External braces are generally more accessible and affordable, making them a practical choice for many patients.


Future Trends in Elbow Bracing

Advancements in Technology:
Innovations in materials and design are continually improving the effectiveness and comfort of both internal and external braces. Biodegradable internal braces and smart external braces with sensors for real-time monitoring are among the exciting developments on the horizon.

Personalized Medicine:
The trend towards personalized medicine is also influencing elbow bracing. Customized braces tailored to an individual’s anatomy and injury specifics are becoming more common, enhancing treatment outcomes.

Rehabilitation Integration:
Future elbow braces are likely to integrate more seamlessly with rehabilitation programs, incorporating features that support physical therapy exercises and monitor progress.

Both internal and external elbow braces offer distinct advantages and are valuable tools in the management and treatment of elbow injuries. The choice between them depends on various factors, including the severity of the injury, the patient's activity level, recovery goals, and financial considerations. Advances in medical technology continue to enhance the effectiveness of both types of braces, promising better outcomes for patients in the future.

As always, it is crucial for patients to consult with healthcare professionals to determine the most appropriate treatment for their specific needs. Whether opting for an internal or external brace, the ultimate goal is to ensure a safe and efficient recovery, enabling patients to return to their daily activities or sports with confidence and stability.



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