Reconstructive Arm Elbow Surgery
What is reconstructive arm elbow surgery?
Reconstructive arm elbow surgery is a procedure that restores the function and appearance of the arm elbow after injury, disease or birth deformities prevent normal elbow use and cause disfigurement. This may involve repairing damaged structures or replacing damaged or missing structures with adjacent skin, bones, muscles,ligaments, tendons or nerves to restore function and appearance. This may also involve fusing bones of the wrist (arthrodesis) or a joint replacement (arthroplasty) to alleviate pain.
When is reconstructive arm elbow surgery performed?
One of the more common problems is torn muscle tissue in the case of lateral epicondylitis or tennis elbow on the outside of the elbow. Surgery is necessary in some cases to remove the torn muscle fibers and bone spurs. A similar problem on the inside of the elbow is medial epicondylitis or golfer’s elbow. It is similarly treated as lateral epicondylitis. Distal biceps tendon ruptures usually can be reattached but in chronic cases may require a bridging tendon graft.
Ligament tears of the elbow are not uncommon particularly in the elite overhead athlete such as pitchers, quarterbacks and tennis players. The ulnar collateral ligament is reconstructed using a tendon graft from the forearm (Tommy John procedure). Posterolateral elbow instability can develop and require a similar reconstruction. Arthroscopic surgery may be used to remove loose bodies or spurs within the elbow joint restoring motion and preventing arthritis from progressing.
Ulnar nerve entrapment at the elbow or cubital tunnel syndrome may require surgery in advanced cases and occasionally following a failed initial surgery it has to be released from scar tissue and placed safely beneath a muscle to relieve the problem. Radial tunnel syndrome is also a common condition of nerve entrapment at the elbow. It usually resolves with rest, medication and therapy but in some cases, surgical decompression may be needed. Pronator syndrome involves the compression of the median nerve at the elbow level. It is treated similarly to radial tunnel syndrome.
Bone spurs may develop at the back of the elbow leading to a condition called olecranon bursitis. This usually resolves the removal of the spur to eradicate the condition. In the same area, the triceps tendon inserts. In some cases, the tendon tears off the bone and must be reinserted surgically.
Elbow fractures represent one of the most complex problems as it is critical to restore joint congruity and alignment to minimize the chance of arthritis. By placing pins, screws and plates the fracture may be put back in place and held together for the 6 weeks usually needed for healing.
Reconstructive arm elbow surgery should be performed by a fellowship trained upper extremity surgeon with significant expertise in the type of procedure planned. Dr. Knight has performed cutting edge procedures for over 25 years with considerable success. He was the head of a limb reattachment and restoration center for 8 years and frequently has performed most reconstructive arm elbow surgery procedures not only salvaging limbs but returning these patients back to their livelihood. He has also performed many reconstructive arm procedures on elite athletes and weekend warriors.
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