Elbow Fracture Reconstruction Surgery for Restoring Function and Relieving Pain
To help you discuss elbow fracture reconstruction surgery as a treatment option for your elbow injury with your orthopedic surgeon, here’s a breakdown of this surgical procedure.
What Is Elbow Fracture Reconstruction Surgery?
Elbow fracture reconstruction is a surgical procedure for repairing and restoring an elbow damaged by severe trauma or injury. This procedure may include repairing damaged structures, or replacing missing or damaged structures with adjoining skin, muscles, ligaments, tendons, bones, or nerves. It may also include bone fusion (arthrodesis) or replacement of a joint (arthroplasty) to mitigate pain.
What Are the Types of Elbow Fractures?
There are three types of elbow fractures:
- Radial head and neck fractures occur in the head and neck portion of the radius bone.
- Olecranon fractures occur at the bony prominence of the ulna.
- Distal humerus fractures occur in the distal humerus of the arm, and may involve damage to the nerves and arteries.
Elbow fracture reconstruction surgery is recommended when the elbow fracture prevents the bones from healing in alignment leading to continued pain, dysfunction, and limited use.
What Happens Before Elbow Fracture Reconstruction Surgery?
Prior to elbow fracture reconstruction surgery, the orthopedic surgeon may perform the following steps:
- Physical exam to inspect blood circulation and nerves affected by the fracture
- X-ray, CT scan, or MRI scan to assess surrounding structures and broken bones
- Blood tests
- Depending on the type of fracture, the patient may be given a tetanus shot
- A discussion with the orthopedic surgeon about what the medications, and supplements, foods and beverages to avoid
How Is Elbow Fracture Reconstruction Surgery Performed?
The surgical treatment for elbow fractures depends on the severity and type of the fracture.
External fixation is used for severe open fractures. For this procedure, the orthopedic surgeon follows these steps:
- Make small cuts in the skin and insert metal pins through the bones.
- Attach carbon fiber bars to the pins outside the skin.
The external fixator functions as a frame and holds the elbow in a proper position, and gives the skin time to heal, before a second operation.
Open reduction and internal fixation (ORIF) is most commonly used to treat elbow fractures. During ORIF the orthopedic surgeon repositions (reduces) bone segments into their normal alignment, and holds them in place with screws and plates attached to the outside of the bone. Depending on the fracture, the orthopedic surgeon may perform the following:
- Ulnar nerve transposition: The orthopedic surgeon slightly moves the ulnar nerve to make room and to prevent it from being injured during surgery.
- Bone grafting: The orthopedic surgeon replaces the bone using bone from a donor or elsewhere in the patient’s body if their existing bone has been lost or crushed.
- Osteotomy: The orthopedic surgeon incises the tip of the elbow (olecranon) to better visualize the bone segments.
Total elbow replacement (arthroplasty) is performed during cases of severe fractures, where the humerus is so badly damaged that it cannot be repaired and needs to be replaced with a metal and plastic implant. During arthroplasty, the orthopedic surgeon performs the following procedure:
- Remove the fragments of bone
- Attach an implant to the humerus
- Attach an implant to the ulna
- Link the two implants to form a hinge
Arthrodesis (fusion) is used for severe elbow injuries for more active or younger individuals, rather than a total elbow replacement. During arthrodesis, the orthopedic surgeon applies plates and screws to make the olecranon and humerus grow together, or fuse as one bone.
What Happens After Elbow Fracture Reconstruction Surgery?
While exact instructions vary by procedure, the orthopedic surgeon will provide the patient with the following guidelines:
- Take pain medication as needed
- Keep arm immobile for several weeks with the aid of a sling to allow bone healing
- Follow instructions on dressings and incision care as well as arm care, like application of ice for comfort
- Participate in physical therapy to prevent arm stiffness, strengthen muscles, and restore range of motion.
- Follow a healthy diet and take supplements high in vitamin D and calcium to promote bone healing.
- Go to scheduled follow-up appointments to monitor progress, and remove staples or stitches, if necessary.
What Are the Risks and Complications of Elbow Reconstruction Surgery?
As with any surgery, some of the potential risks and complications of Elbow Fracture Reconstruction Surgery include infection, bleeding, swelling, pain, and damage to the bone and surrounding soft tissues.
If your elbow has been hurt and you need help, we’re here for you. See if Elbow Fracture Reconstruction surgery is right for you.