Our Summary

This research article focuses on elbow injuries in elderly people, which make up about 4.1% of all fractures in this age group. These injuries often happen due to low-energy events such as falling from a standing position. The complexity of treating elbow injuries in older patients is amplified due to factors like poor bone quality, fragmentation of the joint, and existing conditions like arthritis. Other medical conditions and the patient’s overall health and ability to function also play a significant role in deciding whether surgery is the right course of treatment. The study looks at various kinds of elbow injuries including fractures of the distal humerus, radial head, and olecranon, as well as elbow dislocation and a combination of injuries known as a ’terrible triad'.

FAQs

  1. What are some of the common challenges faced in elbow surgery for elderly patients?
  2. How do preexisting conditions influence the decision making for elbow surgery in geriatric patients?
  3. What is the prevalence of elbow injuries in the elderly population?

Doctor’s Tip

A helpful tip a doctor might tell a patient about elbow surgery is to follow the post-operative care instructions closely, including physical therapy exercises to help regain strength and range of motion in the elbow. It is important to be patient and consistent with rehabilitation to ensure a successful recovery. Additionally, avoiding activities that put excessive strain on the elbow joint can help prevent reinjury.

Suitable For

Patients who may be recommended for elbow surgery typically include those with:

  1. Distal humerus fractures
  2. Elbow dislocations
  3. Elbow trauma
  4. Olecranon fractures
  5. Radial head fractures
  6. Terrible triad injuries

Additionally, elderly patients with elbow injuries may require surgery due to factors such as insufficient bone quality, comminution, articular fragmentation, and preexisting conditions like arthritis. It is important to consider medical comorbidities and baseline level of function when making surgical decisions for these patients.

Timeline

Before elbow surgery:

  1. Patient sustains an injury to the elbow, such as a fracture, dislocation, or other trauma.
  2. Patient undergoes initial evaluation and diagnostic imaging, such as X-rays or MRI, to determine the extent of the injury.
  3. Orthopedic surgeon or other healthcare provider discusses treatment options with the patient, including the possibility of surgery.
  4. Patient may undergo pre-operative testing, such as blood work or EKG, to ensure they are medically cleared for surgery.
  5. Surgery is scheduled and patient receives pre-operative instructions, such as fasting before surgery and medication guidelines.

After elbow surgery:

  1. Patient undergoes the surgical procedure to repair the elbow injury, which may involve internal fixation with screws or plates, ligament repair, or other techniques.
  2. Patient is monitored in the recovery room immediately following surgery and may stay in the hospital for a period of time for observation.
  3. Patient begins physical therapy and rehabilitation to regain strength and range of motion in the affected elbow.
  4. Patient may require pain medication and follow-up appointments with the surgeon to monitor healing and progress.
  5. Over time, patient gradually resumes normal activities and may experience improvements in elbow function and pain levels.

What to Ask Your Doctor

  1. What type of elbow surgery do you recommend for my specific injury?

  2. What are the potential risks and complications associated with this surgery?

  3. What is the recovery process like after this surgery?

  4. How long will it take for me to regain full function and range of motion in my elbow?

  5. Will I need physical therapy after the surgery?

  6. How soon can I return to my normal activities, including work and exercise?

  7. Are there any long-term effects or limitations I should be aware of after this surgery?

  8. How successful is this type of surgery for patients in my age group?

  9. Are there any alternative treatments or therapies that I should consider before proceeding with surgery?

  10. What can I do to optimize my outcome and speed up my recovery after the surgery?

Reference

Authors: Onizuka N, Switzer J, Myeroff C. Journal: Orthop Clin North Am. 2021 Oct;52(4):381-401. doi: 10.1016/j.ocl.2021.05.009. Epub 2021 Jul 29. PMID: 34538350