Our Summary

This research paper discusses the various treatment options for patients who continue to experience instability, partial dislocation (subluxation), or complete dislocation of the elbow after initial treatment. It emphasizes the importance of first restoring the bony structures of the elbow, especially the coronoid bone. Once that’s done, doctors can then address issues with soft tissues and ligaments. If needed, additional stabilization procedures - both static (stationary) and dynamic (moving) - can help keep the elbow properly aligned. It’s crucial to avoid complications during these complex procedures and to quickly identify and address any issues that do occur after surgery. The paper aims to provide an overview of current best practices for treating persistent or recurring elbow instability or dislocation.

FAQs

  1. What are the common complications associated with elbow surgery?
  2. What are the current treatment options for patients experiencing persistent and recurrent elbow subluxation or dislocation after a primary stabilization?
  3. How is elbow alignment and ulnohumeral joint stability restored during elbow surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about elbow surgery is to follow postoperative rehabilitation protocols diligently. This may include physical therapy exercises to improve range of motion and strengthen the muscles around the elbow joint. Compliance with these protocols can help ensure a successful recovery and reduce the risk of complications or recurrent instability. Additionally, it is important to communicate any concerns or changes in symptoms to your doctor promptly to address any issues that may arise.

Suitable For

Patients who are typically recommended for elbow surgery include those with persistent and recurrent elbow instability, such as joint incongruity, subluxation, or dislocation. These patients may have bony deficiencies, soft-tissue injuries, or ligamentous instability that require surgical intervention to restore elbow alignment and maintain joint stability. Patients with complications following primary stabilization procedures may also be candidates for revision surgery to address ongoing instability. It is important for surgeons to carefully evaluate each patient’s individual case to determine the most appropriate treatment approach for their specific condition.

Timeline

Before elbow surgery:

  1. Patient experiences persistent and recurrent elbow instability.
  2. Diagnosis is made through physical examination, imaging studies, and possibly arthroscopy.
  3. Treatment options are discussed with the patient, including the risks and benefits of surgery.
  4. Preoperative preparations are made, such as obtaining medical clearance and scheduling the surgery.

After elbow surgery:

  1. Patient undergoes the surgical procedure to address the underlying cause of elbow instability, such as joint incongruity or ligamentous injury.
  2. Postoperative care includes pain management, physical therapy, and monitoring for complications.
  3. Patient follows a rehabilitation protocol to regain strength and range of motion in the elbow.
  4. Follow-up appointments are scheduled to monitor the healing process and assess the outcome of the surgery.
  5. Patient may experience improvements in elbow stability and function over time, with the goal of returning to normal activities.

Overall, the timeline of a patient’s experience before and after elbow surgery involves a comprehensive evaluation, surgical intervention, postoperative care, and rehabilitation to achieve optimal outcomes in terms of elbow stability and function.

What to Ask Your Doctor

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

  2. How long will the recovery process be after the surgery?

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

  4. Will I need physical therapy or rehabilitation after the surgery? If so, for how long?

  5. What type of post-operative pain management options will be available to me?

  6. How successful is this type of surgery in treating persistent or recurrent elbow instability?

  7. What are the expected outcomes of the surgery in terms of range of motion and overall function?

  8. How soon after the surgery can I return to normal activities, such as work or sports?

  9. Are there any alternative treatment options to surgery that I should consider?

  10. How many of these surgeries have you performed, and what is your success rate with this procedure?

Reference

Authors: Foster BK, Ayalon O, Hoyer R, Hoyen HA, Grandizio LC. Journal: J Hand Surg Am. 2024 Apr;49(4):362-371. doi: 10.1016/j.jhsa.2023.10.015. Epub 2023 Nov 23. PMID: 37999700