Elbow Conditions are some of the most common causes of chronic pain in the United States and affect millions of peoples everyday lives. At Advanced Orthopedics And Hand Surgery Institute, our doctors not only take the time to help their patients suffering from chronic pain, but also offer surgery and treatment options as well.
Why Is Elbow Surgery Important?
Generally speaking, elbow injuries are nothing to laugh about. They are as common as rotator cuff tears and carpal tunnel syndrome. The elbow is a very important joint that is held together by ligaments, muscles, and tendons. It functions to flex and extend the arm and rotate the hand, allowing us to properly and accurately position our hand in space. Any damage to the elbow may prevent this function and impart significant disability to our day-to-day activities.
Common Elbow Injuries
When you’re dealing with elbow pain, the injury can usually be grouped as a one-time event, wear-and-tear related, or due to a disease. Some of these injuries may require surgery, such as in elbow dislocation or severe cubital tunnel syndrome. Others can usually be healed with rest and ice, such as tennis elbow and bursitis.
These are instant injuries that occur when playing a sport or during a fall.
• Fractured elbow — Fractured elbows aren’t common, but they can occur in contact sports, car accidents, and other traumatic events. Unlike many bone breaks, you may still be able to move your elbow even when fractured.
• Dislocated elbow — If one of the bones that makes up your elbow gets knocked out of place, this is an elbow dislocation. The most common occurrence happens when you put your hand out to brace yourself during a fall. It also happens when you swing a toddler by their forearms, reason enough to never do that again.
• Sprains/strains — Muscles are strained when stretched or torn, ligaments are sprained. Overdoing it in sports is the most common cause of these injuries, which are usually healed with rest, ice, and then stretching.
These elbow injuries occur over time. They may be due to repetitive motions at work or when hitting a golf or tennis ball.
• Tennis/golfer’s elbow — These are tendinitis, which is swelling in the tendons around your elbow caused by overuse. Tennis elbow affects the outside of the elbow; golfer’s elbow the inside.
• Bursitis — Your bursa sacs have fluid in them and are found in your joints. Their job is to cushion your bones, tendons, and muscles. Repetitive motion can cause the bursa to become inflamed.
• Trapped nerves — Carpal tunnel syndrome gets the most attention, where nerve compression occurs where the nerve pass through the wrist, but the elbow can develop similar problems. Cubital tunnel syndrome happens when the ulnar nerve gets squeezed as it runs along the inside of your elbow through the cubital tunnel. Radial tunnel syndrome affects the radial nerve on the outside of the elbow.
• Stress fractures — Stress fractures are more common in the legs and feet, but they can occur in the elbow. Throwing motions, such as pitching a baseball, usually causes elbow stress fractures.
Elbow pain is usually a side issue of various diseases, but it is not the main symptom.
• Arthritis — Rheumatoid arthritis happens when your immune system attacks your body’s healthy tissue, causing swelling in the joints, such as the elbow. Osteoarthritis occurs with wear and tear over time.
• Lyme disease — Carried by ticks, Lyme disease causes nervous system problems, leading to pain in your joints.
• Lupus — Your immune system attacks your joints and organs.
Overuse injuries of the elbow give rise to common conditions including bursitis and tendonitis. While the most common inflammation of the elbow tendons is dubbed 'tennis elbow', tennis players are far from being alone in suffering from it. Golfers, drummers, and anyone whose occupation involves repeated elbow movements are prone to it. Treatment options for tennis elbow are plentiful and include a multitude of options, including physical therapy, injections like cortisone or PRP, shockwave therapy, and ultimately minimally invasive surgery if necessary. The expert elbow surgeons at AOHSI , Drs. Ramin Ghobadi and Peter DeNoble will help tailor your treatment to what is best in your situation.
You may need blood work and clearance from your medical doctor to undergo anesthesia. Unless your surgeon specifically advises you, no preparations are usually necessary.
Elbow Surgery Procedure
The team at Advanced Orthopedics & Hand Surgery employs arthroscopic methods if possible to minimize incision length and shorten recovery times. Obviously, different sorts of elbow injuries demand different surgical solutions. For a dislocated elbow, for instance, associated muscles, ligaments, or tendons may need to be reattached. Tennis elbow that doesn’t improve in 6-12 months with conservative methods may require surgery, where the damaged portion of the tendon is removed and the healthy remaining tendon is reattached to the bone. In cubital tunnel syndrome, the ulnar nerve is compressed through the cubital tunnel at the elbow. Surgery can simply create more space, it may shift the nerve to the front of the elbow, it may move the nerve under a layer of fat or under a muscle, or it may trim the bump of the inner portion of the elbow, where the ulnar nerve passes.
If you require any type of elbow surgery, the team at Advanced Orthopedics & Hand Surgery Institute will discuss the possible surgery options with you during your examination and consultation.
How Long Will the Procedure Last?
Elbow surgery procedures generally last about 45 minutes to an hour long.
Can Elbow Surgery Help Treat Nerve Pain?
Ulnar nerve compression at the elbow (also known as
cubital tunnel syndrome) is the most common nerve-related reason for numbness and electricity-type pain shooting into the ring and small fingers. This can also be accompanied by loss of hand strength, causing weakness with daily activities like opening jars and turning keys. These symptoms can develop over the course of weeks to months without a specific cause. Often you will wake up at night with numbness and pain, particularly made worse with flexion of the elbow. As the nerve compression persists, weakness of the hand may worsen, and thinning of the muscles may progress. If left untreated, the weakness is often irreversible. If you have any pain or tingling sensations or weakness in your hand, it is best to be evaluated by the experienced elbow surgeons at AOHSI.
Elbow Surgery Recovery
You will need to be in a soft dressing or splint for 5 days. Shortly after 5 days, you will remove the dressing and begin range of motion. After two weeks post op, you will come to the office for suture removal.
Will I Need Physical Therapy After Elbow Surgery?
Generally, there is no need for physical therapy. Although, there are always exceptions if a certain patient is apprehensive or has difficulty regaining full range of motion.
Elbow Surgery Success Rate
Elbow surgery has around a 90 percent success rate for relieving pain, returning strength and function, and allowing the patient to get back to the activity or sport. Of course, this can vary by the patient.
What Are My Risks Post Surgery?
Elbow surgery is very successful, but it does come with some risks. These involve the usual surgical risks of infection, excessive bleeding, blood clot formation, and reaction to anesthesia. Specific to arthroscopic elbow surgery, there is a potential risk of nerve damage.
When Can I Resume Normal Activities After Elbow Surgery?
When you can return to your normal activities is predicated on the type and extent of elbow surgery you’ve had. If you’ve only had minor surgery, such as to remove bone chips in the elbow area, you may be able to return to work in just a few days, and begin using your elbow shortly thereafter. More complicated procedures, such as moving nerves or tendons, will involve longer periods to get back to normal use. It may be weeks before you can fully use your arm normally. Returning to a sport, such as tennis, could take months. We’ll discuss your timeline with you prior to your surgery.