Arm & Elbow
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Injuries and disorders of the elbow can impact nearly every aspect of daily life. Weiss orthopedic surgeons are experts in treating most elbow issues, including:
- Bicep Tendon Repair
- Elbow, Humerus and Ulna Fractures
- Tennis Elbow
- Tommy John Surgery
Bicep Tendon Repair
Bicep tendon repair is needed when the tendons attaching the bicep muscle to the arm are torn, either at the shoulder or the elbow. When the tear occurs at the shoulder, other parts of the shoulder can be damaged including the rotator cuff tendons.
Often referred to as a bicep tear, this condition is most commonly associated with weightlifters, but can also occur as a result of injury from falling hard on an outstretched arm or lifting something too heavy. It is also possible for the tendons to wear out and fray over time, usually due to age or repetitive overhead sports such as swimming and tennis.
- an immediate sharp pain in the bicep near your elbow, followed by bicep muscle weakness, stiffness and bruising
- an audible snap or pop
- sudden loss of arm function, difficulty in turning the palm up or down
- a bulge on the bicep
- physical therapy
- surgery (re-anchors torn tendon to the bone)
Elbow, Humerus and Ulna Fractures
A fracture is a partial or complete break in the bone. When a fracture occurs, it is classified as either open or closed:
- open fracture – the bone exits and is visible through the skin, or where a deep wound exposes the bone through the skin
- closed fracture – the bone is broken, but the skin is intact
Fractures occur when there is more force applied to the bone than the bone can absorb. Bones are weakest when they are twisted. Breaks in bones can occur from falls, trauma, or as a result of a direct blow or kick to the body.
- sudden, intense pain
- swelling of the joint or in the area immediately above or below
- obvious deformity in the injured area
- warmth, bruising and tenderness
- numbness or a cool sensation in the forearm, hand or fingers
- difficulty moving or using the injured area in a normal manner
- medication (to control pain)
Traction is the application of a force to stretch certain parts of the body in a specific direction. Traction consists or pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone to allow the bone ends to align and heal.
Surgery may be required to put certain types of broken bones back into place. Occasionally, internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place to allow alignment and healing.
Lateral epicondylitis, commonly called tennis elbow, is characterized by pain on the outside of the elbow. Pain is caused by damage to the tendons that bend the wrist backward away from the palm. Tennis elbow, as the name implies, can be caused by the repetitive force of the tennis racket hitting balls in the backhand position, but you do not have to play tennis to have this condition. Your forearm muscles, which attach to the outside of the elbow, may become sore from excessive strain by a number of other repetitive motions, including gripping, lifting, acute injury (heavy lifting), gardening, typing, etc.
- pain may be felt along the outside of the forearm and elbow
- pain may increase down to the wrist, even at rest, if you continue the activity causing pain
- pain may also persist when the arm and hand are placed palm-down on a table and you try to raise your hand against resistance
Stopping the activity that is causing you pain is the best way to treat Tennis Elbow. Other methods include:
- ice pack application (to reduce inflammation)
- strengthening exercises
- anti-inflammatory medications
- corticosteroid injections
Surgery for tennis elbow may involve:
- cutting (releasing) the tendon
- removing inflamed tissue from the tendon
- repairing (reattaching) tendon tears
Tommy John Surgery
Tommy John surgery, or ulnar collateral ligament (UCL) reconstruction, is a surgical procedure in which a torn ligament in the elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, knee, or foot). It is a common surgery among collegiate and professional athletes.
- pain in the elbow during and after throwing activities
- numbness and tingling in the hand
- a popping sound heard when making a pitch
The surgery is named after Tommy John, a pitcher for the Los Angeles Dodgers who was the first professional athlete to successfully undergo the operation in 1974.
Using your own tissue, a ligament is reconstructed and woven in a figure-eight pattern through tunnels that have been drilled in the ulna and humerus bones. Many times during reconstruction, the ulnar nerve will need to be moved in an effort to keep it from being irritated during throwing. This tissue is then secured in the bone with either screws or sutures depending on the surgical method employed.