Elbow
Elbow Arthritis
The Injury
Arthritis can affect the elbow in the same way that it can affect the weight bearing joints such as the hip and knee. The type of arthritis may be inflammatory or degenerative. Arthritis is a condition whereby the cartilage surfaces of the joint become damaged and deteriorate over time, resulting in the loss of the cushioning material between the bones.
Symptoms
Symptoms associated with this condition include elbow pain and stiffness. At Regional Orthopedics, the pain and stiffness associated with advanced arthritis can be effectively relieved with an elbow replacement. This procedure involves resection of the deteriorated arthritic surfaces of the joint followed by the bonding of synthetic implants to these surfaces, which will allow for the restoration of painless motion. For less advanced cases of arthritis, such as mild or moderate cartilage loss, symptoms can be managed with non-surgical measures such as oral medications, injectable medications and a physical therapy program.
The Procedure
This procedure typically requires an overnight hospital stay followed by 8 weeks of physical therapy.
Elbow Dislocation
About the Elbow
The elbow is complex joint that is held together by strong ligaments.
The Injury
As a result of a traumatic event, the ligaments can be torn and the elbow joint can become dislocated. This injury pattern is initially treated with a reduction of the elbow joint, typically in the emergency room setting, with application of a splint. If the reduction is adequate and the joint is relatively stable, a nonsurgical approach can be employed whereby the ligaments can be allowed to heal in a brace and elbow motion can be introduced in a progressive fashion. In some cases, an adequate reduction cannot be achieved or the reduction may be unstable. This can occur for a variety of reasons including associated fractures. In these cases the recommended treatment is a surgical repair.
The Procedure
At Regional Orthopedics, this injury pattern is treated utilizing necessary repair options including fracture repair, ligament repair or reconstruction, hinged articulating external fixation devices. The goal of treatment is to restore elbow stability and range of motion.
Elbow Fracture
About Fractures
There are many fracture patterns which can affect the elbow. Typical fractures involve the olecranon process, radial head, humeral condyles and distal humerus. Nondisplaced fractures can be treated in a long arm cast with immobilization of the elbow. Displaced or unstable fractures of the elbow require surgical treatment.
The Procedure
The surgical procedure involves piecing back together the broken fragments of bone in a way that restores the normal skeletal anatomy and also restores the normally smooth and congruent joint surfaces. Once the pieces are appropriately positioned, metal implants are applied for the purpose of holding the reduced fragments together rigidly in a fixed position. This ‘rigid fication’ of the bone allows for rapid healing and also for the introduction of motion during the healing phase for the purpose of preventing joint stiffness and muscle atrophy.
Ulna Neuritis/Instability
About Ulna Neuritis/Instability
This condition is related to entrapment or instability of the ulna nerve in the vicinity of the elbow. The nerve normally travels past the elbow on the medial side through a passageway called the cubital tunnel posterior to the medial epicondyle. As a result of repetitive overuse, the nerve can become compressed within the cubital tunnel or unstable, causing the nerve to become distressed. Typical symptoms of this condition are pain over the radial aspect of the elbow and numbness or ‘pins and needles’ over the ulna aspect of the hand.
The Condition
This condition can be managed effectively with oral anti-inflammatory medication, steroid injection, activity modification and exercises. In some cases, the symptoms do not resolve with medical treatment and a surgical correction is necessary.
The Procedure
At Regional Orthopedics, this condition is treated surgically through a small 2-inch incision over the medial side of the elbow where it is hidden from view. The nerve is decompressed by releasing the connective tissue sheath which creates a boundary for the tunnel, thereby relieving physical pressure. In cases where the nerve is unstable, it can be stabilized by transposition to an anterior position in the elbow.
Epicondylitis
About Epicondylitis (Tennis Elbow)
This condition is more commonly known as tennis elbow or golfer’s elbow. It is caused by repetitive overuse of the extensor/flexor muscles of the forearm, which results in partial tearing of the common tendon origin.
The Symptoms
The symptoms of this condition are pain over the lateral or medial side of the elbow, pain in the elbow and forearm with activity and elbow stiffness. This condition is often adequately treated with oral anti-inflammatory medications, steroid injection, bracing and exercises. Cases of chronic tendinitis unresponsive to nonsurgical treatment can be effectively managed with a surgical repair of the torn tendon.
The Procedure
This is an ambulatory procedure performed through a small 1.5-inch incision. Recovery time is typically a few weeks.
