An even closer combo to 'elbow' would be
Elle Bow.
Still, I don't think middle names are important for people meeting up with a girl with a name like
Ella or
Elle Bow for the first time.
That being said, there would be a time when you will start being called Elbow e.g. weddings where your name is announced as
Elle Bow Whaddahellyouat. Some people would giggle at you.
Ella Bow would be less likely to be called Elbow but it's still likely.
~I luv
London Tipton 'cause she's an idiot like moi~
My pinool:
http://www.behindthename.com/pnl/149249