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Elbow

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For all of your elbow treatment needs in the Muskegon & Grand Haven, MI areas be sure to contact Orthopaedic Associates of Muskegon. To learn more contact our office today!

The elbow is a complex hinged joint that links movements of the shoulder to the hand, and helps facilitate nearly all activities of daily living. Injury or pathology involving the bone, ligaments, or tendons around the elbow can result in significant functional deficits due to pain, instability, and decreased range of motion. Our elbow specialists are highly skilled in treating elbow disorders, and include a broad range of expertise developed through personal experience and advanced fellowship training focused on elbow reconstruction, trauma, and sports related injuries.

OAM Specialties

Urgent Care

Injuries can happen anytime so we have immediate appointments available at our Muskegon office. Our orthopaedic urgent care is open to accommodate same day visits for the evaluation of elbow injuries.

Conditions

Distal Biceps Tendon Rupture

The biceps muscle originates from two sites on the shoulder blade and attaches just past the elbow on the radial tuberosity of the radius. It functions to flex the elbow and to supinate the forearm or to rotate the palm up. The distal attachment of the biceps can tear when there is a significant or unexpected load across the elbow. Loss of this tendon results in significant strength loss with elbow flexion and supination. When the distal biceps tendon ruptures, surgical repair is recommended in most cases.

Distal Triceps Tendon Rupture

The triceps muscle originates from the upper humerus and shoulder blade and attaches to the olecranon tip at the elbow. It functions to extend or straighten the elbow. Injury to this tendon can result in rupture. This manifests as significant weakness in straightening the elbow. This is the only tendon that extends the elbow and should be surgically repaired if torn.

Elbow Arthritis

Arthritis is the loss of the smooth covering over the ends of bones. When this coating is gone, bone rubs on bone and causes inflammation, pain, and decreased range of motion. Arthritis can be caused by ligament injury, previous trauma, or bad luck. Early treatments include therapy exercises, NSAIDs, cortisone injections, and rest. Arthroscopic or open debridement procedures can also help with symptoms if non-operative treatments fail. Total elbow replacement can significantly help with the symptoms, but there is a lifelong lifting restriction of 10 lbs., and there are high rates of revision surgery in younger patients.

Elbow Contractures

The elbow has a tendency to become stiff and lose motion after injury. Loss of some elbow extension is almost guaranteed after significant fractures or dislocations, but even minor injuries can sometimes result in loss of motion. In some instances, the contractures are severe and limit function. In these cases, aggressive physical therapy and stretching are prescribed, in addition to splints that actually “crank” on the elbow to force it straight or into flexion. If non-operative measures do not restore a functional range of motion, sometimes surgery is needed to remove the scarred capsule and other obstructions to elbow movement.

Elbow Instability

The elbow is stabilized by strong ligaments on the inside (medial aspect) and the outside (lateral aspect). When these ligaments are damaged, it can result in partial dislocations or subluxations of the elbow during certain movements, which causes pain. Repetitive stress (pitching) or trauma (elbow dislocation) can result in disruption of these ligaments. Patients are usually treated with rest and physical therapy at first. If the ligaments do not heal on their own, surgical repair or reconstruction may be necessary.

Lateral Epicondylitis (Tennis Elbow)

Also termed “tennis elbow,” people with lateral epicondylitis experience pain along the outside of the elbow over the lateral epicondyle. This pain is usually worse with gripping activities or movements involving wrist extension. The forearm muscles that extend the wrist and fingers originate over the lateral epicondyle, and when this tendon attachment becomes inflamed, it results in significant pain. In some cases, it can become painful with even basic activities of daily living. It is initially treated with a combination of rest, ice, NSAIDs, eccentric therapy exercises, and cortisone injections. Surgical debridement and tendon repair may be necessary when non-surgical treatment therapies have not been effective.

Medial Epicondylitis (Golfer’s Elbow)

Also termed “golfer’s elbow,” people with medial epicondylitis experience pain along the inside of the elbow over the medial epicondyle. This pain is usually worse with gripping activities or movements involving wrist flexion. The forearm muscles that flex the wrist and fingers originate over the medical epicondyle, and when this tendon attachment becomes inflamed, it results in significant pain. In some cases, it can become painful with even basic activities of daily living. It is initially treated with a combination of rest, ice, NSAIDs, eccentric therapy exercises, and cortisone injections. Surgical debridement and tendon repair may be necessary when non-surgical treatment therapies have not been effective.

Olecranon Bursitis

The bone at the tip of the elbow is called the olecranon, and the tip lies directly under the skin. Between the skin and the bone there is a small fluid filled sac, called the olecranon bursa, which acts as a lubricant between the skin and bone. With repetitive pressure or trauma, this fluid filled sac can become inflamed and fill with more “fluid” than normal. This results in pain and a swelling around the back of the elbow that almost looks and feels like a water balloon. Treatment consists of rest, ice, NSAIDs, and soft braces. Drainage is rarely necessary.

Osteochondritis Dissecans

Repetitive impact through the elbow in skeletally immature individuals can result in focal areas of cartilage damage, termed osteochondritis dissecans, or OCD. This generally results in pain, swelling, and decreased range of motion. Cartilage is the smooth, soft, covering over the ends of bones where they articulate. When this covering is damaged, it causes pain. This condition is diagnosed with x-rays and usually an MRI. It is initially treated with rest and NSAIDs. In some cases, surgical debridement or stabilization is required.

Procedures

Learn about a procedure:

Distal Biceps Tendon Repair

distal biceps tendon repair

When is it Time to Think About Surgery?

Distal biceps tendon rupture results in significant elbow flexion and forearm supination weakness. Surgical repair of distal biceps tendon injuries is recommended for most patients. 

About the Surgery

This surgery involves re-attaching the biceps tendon to the radial tuberosity just past the elbow. There are several techniques used depending on surgeon preference. Some surgeons make one incision on the front of the elbow, and others make an incision on the front and back. The tendon can be repaired through bone tunnels, with suture anchors, or a cortical button. You are in a splint for two weeks to rest the elbow after the surgery. 

Preparing for Surgery

You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Pre-admission testing (lab work, EKG, chest x-ray) will be scheduled prior to your surgery. Medications such as anti-inflammatory medications, aspirin, and blood thinning medications should be stopped one week before surgery unless otherwise specified by your family doctor.

What to Expect After Surgery

You will be in a splint at the wrist to rest the involved tendon for about two weeks after surgery, at which time you can begin active range of motion. Strengthening begins at six weeks post-surgery. 

Complications and Risks of Surgery

Risks of surgery include pain, bleeding, infection, damage to surrounding structures, stiffness, loss of function, failure of the tendon to heal, or blood clots in the arm that can go to the lung (pulmonary embolus). Anesthetic risks include heart attack, stroke, blindness, and death. 

Recovery

Strengthening begins six weeks after surgery. You will be allowed to ease into activities as your strength allows. The tendon is generally healed by 12 weeks and unrestricted activity, again based on strength and progress in recovery, is permitted. 

Return to Work

Return to work is highly individualized.  Jobs requiring only deskwork may be able to return within 1-2 weeks, whereas heavy lifting manual labor jobs may require 3 months or longer to return without restrictions. 

Lateral Epicondylitis (Tennis Elbow) Surgery

tennis elbow 

When is it Time to Think About Surgery?

Lateral epicondylitis (Tennis Elbow) is an inflammation of the tendons that originate on the outside of the elbow, which predominantly extend the wrist and fingers. The tendon injury is from repetitive stress that causes micro-tears that occur faster than the body can heal. When prolonged splinting, physical therapy, NSAIDs, and cortisone injections have not helped, typically at least 6 months, surgery may be considered. 

About the Surgery

The surgery involves making a small cut over the outside of the elbow. An incision is made in the common extensor tendon and the diseased areas of the tendon are identified. These areas usually involve the extensor carpi radialis brevis tendon. The diseased tendon is removed, the bony attachment is scraped to healthy bleeding bone to promote healing, and the healthy tendon is sutured back together. 

Preparing for Surgery

You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Pre-admission testing (lab work, EKG, chest x-ray) will be scheduled prior to your surgery. Medications such as anti-inflammatory medications, aspirin, and blood thinning medications should be stopped one week before surgery unless otherwise specified by your family doctor.

What to Expect After Surgery

After surgery, you will be in a splint at the wrist to rest the involved tendon for about 6 weeks. You can perform light activities during this time.  

Complications and Risks of Surgery

Risks of surgery include pain, bleeding, infection, damage to surrounding structures, stiffness, loss of function, failure of the tendon to heal, or blood clots in the arm that can go to the lung (pulmonary embolus). Anesthetic risks include heart attack, stroke, blindness, and death. 

Recovery

When the splint comes off at 6 weeks after surgery, physical therapy is initiated. As movement and strength return, you will be allowed to ease back into gentle activities. The tendon should be healed about 12 weeks post-surgery, and based on progress with therapy, you will be allowed to resume more normal activities as your strength allows. 

Return to Work

Return to work is highly individualized.  Jobs requiring only deskwork may be able to return within 1-2 weeks, whereas heavy lifting manual labor jobs may require 3 months or longer to return without restrictions. 

Medial Epicondylitis (Golfer’s Elbow) Surgery

 golferselbow

When is it Time to Think About Surgery?

Medial epicondylitis (Golfer’s Elbow) is an inflammation of the tendons that originate on the inside of the elbow, which predominantly flex the wrist and fingers.  The tendon injury is from repetitive stress that causes micro-tears that occur faster than the body can heal. When prolonged splinting, physical therapy, NSAIDs, and cortisone injections have not helped, typically at least 6 months, surgery may be considered. 

About the Surgery

The surgery involves making a small cut over the inside of the elbow. An incision is made in the common flexor tendon and the diseased areas of tendon are identified. These areas usually involve the flexor carpi radialis or pronator teres muscles. The disease tendon is removed, the bony attachment is scraped to healthy bleeding bone to promote healing, and the healthy tendon is sutured back together. 

Preparing for Surgery

You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Pre-admission testing (lab work, EKG, chest x-ray) will be scheduled prior to your surgery. Medications such as anti-inflammatory medications, aspirin, and blood thinning medications should be stopped one week before surgery unless otherwise specified by your family doctor.

What to Expect After Surgery

After surgery, you will be in a splint at the wrist to rest the involved tendon for about 6 weeks. You can perform light activities during this time.  

Complications and Risks of Surgery

Risks of surgery include pain, bleeding, infection, damage to surrounding structures, stiffness, loss of function, failure of the tendon to heal, or blood clots in the arm that can go to the lung (pulmonary embolus). Anesthetic risks include heart attack, stroke, blindness, and death. 

Recovery

When the splint comes off at 6 weeks after surgery, physical therapy is initiated. As movement and strength return, you will be allowed to ease back into gentle activities. The tendon should be healed about 12 weeks post-surgery, and based on progress with therapy, you will be allowed to resume more normal activities as your strength allows. 

Return to Work

Return to work is highly individualized.  Jobs requiring only deskwork may be able to return within 1-2 weeks, whereas heavy lifting manual labor jobs may require 3 months or longer to return without restrictions. 

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