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Elbow Problems

General

Elbow Anatomy

The elbow is composed of three bones and the muscles, tendons and ligaments that connect them. The three bones are the radius and ulna, which make up the forearm, and the humerus, or upper arm bone.

The elbow is used to carry heavy loads and to position the hand in space. These contrasting tasks require the elbow to be both stable and mobile.

The elbow is a hinge joint, the end of the humerus fits into a notch in the ulna. This allows stable flexion and extension of the elbow. The radius attaches to the humerus at a ball and socket joint, allowing rotation of the forearm and making the hand more mobile.

Four groups of muscles provide motion to the elbow. The flexor-pronator group attaches to the inside of the humerus and flexes the wrist and turns the palm of the hand down. The extensor-supinator group attaches to the outside of the humerus. Its function is to extend the wrist and turn the palm of the hand up. The triceps muscle acts to straighten the elbow, while the brachialis and the biceps muscles flex the elbow.

Although the biceps is responsible for some elbow flexion, its primary job is to turn the palm of the hand up. It does this by rotating the radius when it contracts.

Mechanism of Injury

The elbow can be injured as a result of trauma, repetitive use, or degeneration that occurs with age.

Trauma is a leading cause of injury in the young. Falls on to an outstretched hand, or falls that lead to a sudden twisting injury to the elbow can lead to fractures or dislocations. Repetitive use is a common cause of elbow injury.

People whose occupations require repetitive work, such as carpenters, machinists and typists are particularly susceptible. Athletes who play sports that place stress across the elbow, such as baseball, tennis, golf and softball, can develop elbow pain. Finally, normal wear and tear on the joint can accumulate over a lifetime, and lead to tears of the tendons and ligaments without any specific injury.

Text supplied by www.arthrex.com and www.orthoillustrated.com

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What is Arthroscopy?

The word arthroscopy originates from a Greek word, artros (joint), and skopos (to see). In today's terms it is a procedure that makes it possible to see the inside of the joint and the spaces around the joint in order to identify damaged tissue and lesions and to treat them. The arthroscope allows a surgeon to see an injury and to treat it through special small instruments.

Arthroscopy requires small incisions and patients recover quicker and have a shorter post operative pain period as with open surgery. Patients are also capable of going home sooner after an arthroscopic procedure.

Arthroscopic surgery is an advanced surgical technique with little risks for patients and with excellent results. Every year thousands of people are treated by arthroscopic surgery. When performed by an experienced orthopaedic specialist this innovating procedure can help to relief pain and improve quality of life.

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More info: http://orthoinfo.aaos.org/topic.cfm?topic=A00109

 

Diagnostic Arthroscopy

Overview

Diagnostic arthroscopy makes it possible to diagnose and treat problems in a joint through small incisions. A camera is attached to a scope which makes it possible to view inside the joint.

Incisions

Small incisions are made around the joint through which the scope and surgical instruments are placed.

Inspection

An electrolyte solution flows through the tube into the elbow joint and distends the capsule to improve vision. The image is send to a monitor on which a surgeon can see inside the joint.

Diagnosis

With the video monitor as help, the surgeon can confirm a diagnosis. A range of surgical instruments are available by which an operation can be performed.

End of procedure

The surgical instruments are removed after the procedure and the arm is temporarily immobilized in a sling. Download Diagnostic Arthroscopy document. Potential risks for arthroscopic shoulder and elbow surgery

More info: http://www.orthoinfo.org/topic.cfm?topic=A00646

 

Potential Risks for Arthroscopic Shoulder and Elbow Surgery

Anaesthesia

Complications are not cdownloommon but may occur. Please discuss any questions regarding anaesthesia complications with the anaesthetist who will see you before surgery. Please tell the anaesthetist if you are allergic to any medication or if you are currently taking any medication.

Infection:

Precautions taken to prevent infection include special skin preparation, sterile techniques and the use of antibiotics where appropriate. However, if infection does occur, it may mean further surgery or hospitalisation.

Excessive bleeding or swelling:

Swelling arises as a result of the fluid used during the arthroscopic procedure and it usually clears up within a few hours after the operation. Bleeding that may occur is usually in the form of spots on bandages. In some cases, excessive blood collection in the shoulder or elbow joint must be removed.

Contracture of the joint:

The joint capsule around the ligaments can respond to the operation and restrict the mobility of the shoulder for a period after such a procedure. This contracture can sometimes continue for 2 to 3 months after surgery. It usually clears up completely. An exercise program for such contractures is initiated from shortly after the procedure but the degree of such a contracture varies from person to person. Need for further surgery to clear such a contracture is rarely encountered.

Breaking of tools:

It is possible that a portion of a small surgical instrument may break down within the joint. This complication is rare and if it happens it can usually be removed with arthroscopic techniques. In some cases an incision may be needed to remove the part of a tool.

Nerve damage:

A few smaller nerves and some very important nerves cross the joint where the surgery is done and can be damaged by an arthroscopic procedure. This complication is rare, but when it happens it can have serious consequences that may require additional treatment.

Loss of sensation or pain:

Small sensory nerves lie directly under the skin near the incision areas for arthroscopy. During the insertion of an arthroscope it is possible to damage these small nerves with the result of an area of sensory loss or a focused area of pain and skin sensitivity. These symptoms usually clear up over time.

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