Fracture Fixation in Elbow Joint
The elbow joint, a hinge joint, made up of three bones i.e. the humerus, ulna and the radius often sustains fractures resulting out of a traumatic injury, fall or collision.
The break in the bones is stabilized effectively by the elbow doctor by the technique that is most apt, depending on the severity of the fracture and the number of bones broken in the elbow.
The two types of fracture that the patient may experience, at the elbow are, nondisplaced (in which the bones break but remain in their place) or displaced (in which the bones are torn from their place).
During the fixation:
The technique that is taken up by the elbow doctor to treat fractures which are not displaced is Closed Reduction Technique in which bones are held together by either Internal or External Fixators.Under this technique the elbow doctor physically realigns the bone to its proper position without exposing it to surgery and then with special implants holds them together.
Internal Fixators: The following implants are used as internal fixators:
PLATES- Internal fixators like splints which hold the bones together after being attached to the bone with screws. The plates are removable and nonremovable as the case, may be.
SCREWS- Screw is an internal fixator which may be used individually to hold the broken bones together or may be used with plates, rods or nails. Screws are available in many sizes. The screws may be removed after the bones have healed or left in the elbow.
NAILS / RODS- In some cases where the break is in a long bone, the nail or rod is inserted through the hollow centre of the bone and held with screws at both ends to keep it firmly in place to enable healing.
WIRE / PINS- Wires are used to hold very small bones together which cannot be held together by screws. They are also used as subsequent support to other means of internal fixators.
External Fixators:
External fixators are different from casts or splints. In external fixator the metal pins or screws are inserted inside the broken bone with small holes and are tied to a bar or frame outside the joint to hold the broken elbow together. They are also used as temporary treatment by the elbow doctor in some cases where the patient is not ready to undergo a lengthy surgery.
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After the fixation:
After completing the entire procedure the elbow doctor discusses the medication to be followed, with the patient. The patient is also advised regarding the activities to be avoided to enable quick healing and a post fixation visit is scheduled for a quick follow up after the treatment. The elbow is kept in a sling or a brace to immobilize it.
Probable complications after the fixation:
The complications that could occur after the fixation vary from delay union i.e. the fracture may not heal as expected and takes a longer time to non union i.e. the broken bone fails to heal even after successful treatment or lastly, mal union i.e. the bones may heal with deformity. Other complications that might occur could be an infection from the metal implant or in the punctured wound.
Nature of fractures requiring elbow doctor:
The fractures that do not need the services of an orthopaedic surgeon are fractures that are mildly broken and not displaced. The bones that do not come out of their position and can be reduced physically are treated under closed reduction technique. Break in the humerus, ulna or radius bone that are not multiple and severe are a forte of finesse for the elbow doctor.
Rehabilitation after the fixation:
The main problem that is persistent after fracture in the elbow is that of stiffness which in some cases can stay much after the bones have healed. To enable the patient to strengthen and mobilize the elbow joint the elbow doctor recommends physical therapy treatment with varied modalities and exercise regime to bring a speedy recovery in the elbow.
Benefits of fixation technique:
Closed reduction technique with percutaneous fixation is beneficial to the patient as it does not require any surgery and can be performed by physical fixation. The time taken is much less than exposing the fracture to surgery. Metal implants that are used can be inserted inside by puncture wounds.
More about the elbow doctor:
Dr. Vikas Gupta is a certified and very experienced elbow specialist, at present an integral part of Max Healthcare as head of the Shoulder and Hand division, a newly started wing to facilitate the patients with expertise of Dr. Gupta. As an elbow doctor he has treated patients with all kinds of elbow injuries and conditions with being the first medical specialist to introduce percutaneous fixation in India. Updated with latest technological advancements in techniques, Dr. Gupta is deft in treating patients with minimally invasive techniques. Dr. Gupta has done his residency and MS in Orthopaedics from All India Institute of Medical Sciences and has received further advanced knowledge from Germany and USA. Having performed more than 6000 surgeries over the past 25 years of his career, he is one of the best specialists, surgeon or doctor for the upper extremity conditions. He joined hands with Max Healthcare after an insight into their visionary approach to treat upper extremity ailments. With all facilities and latest technological equipments available at Max Healthcare Dr. Gupta has been provided new wings to take up each case with painless but cost effective techniques.