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Suggest treatment for elbow stiffness

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Posted on Thu, 24 Aug 2017
Question: I have just recently passed the two year anniversary of a major tennis injusry that resulted in the shattering of my elbow, the loss of my Ulnar nerve (lft arm and mostly has taken that pinky finger out of function), and two different sugeries. One 10 days after the horrible fall (once swelling went down) followed by months of PT and little other activity aside from the daily ride to work, occaisional flare's of pain, and slow but steady improvement in range of motion. After six months, I was back down to 37 degrees on my left side amd making slow progress. Then , out of the blue, the arm blew up to football size one morning and was excruciating. I returned to the surgeoen, he said one of the connecting pins had broken and all that bone/muscle/cartilidge rebuilding had fallen apart. Long story longer, but almost done, I didn't like his choice of solutions and found another surgeon who did do corrective surgery but had a totally different approach. Remove and wiring or pins or parts, don't install any new ones as I am too young and active and they'll likely break someday too....leading to a circle of procedures for years to come. He removed everything, any broken fragments and floating tissues and the like and closed it up and put me on an intense PT program. This was a year ago, and finally this past May, he said it's gone as far as it will (around 11 degrees) but he had said it would never go straight and I am happy with the results and 11 vs. 53 which is where I was a year ago. On my last visit he was excited it was successful, congratulated on my efforts and persistence and set me free to do "whatever activities I think I can handle" SO, my question is, I havent had much luck with returning to a regular exercise regime as I still experience discomfort after just a normal day. I am happy that I can again lift things, type, cook, etc, etc. But I have not been able to regain any muscle in my left arm, during heat waves it aches terribly and bends less and has very much minimized my motivation to get onto an exercise path. While I can swim and enjoy that, I am very tentative to do anything else arm related (maybe just fear) and have thus avoided the gym, gained weight and don't know how to "start over" after losing two years basically to this ordeal. Any ideas on that and then,more specifically, esp in heat, I notice topical rashes and strange XXXXXXX bruising in that area. I ice and I try to stretch, but I feel as if it gets me no where, thoughts? And thanks for reading . XXXXXXX
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Answered by Dr. Aashish Raghu (2 hours later)
Brief Answer:
Nerve grafting? Bone block can be considered

Detailed Answer:
Hi there,

Thanks for the query.

You have suffered a terrible elbow injury which now presents with its complications, one of which is the elbow stiffness.

The physiotherapy needs to continue to try to improve the range of motion.

The weakness is due to ulnar nerve injury. You can discuss with your Doctor about the potential of nerve grafting or tendon transfer surgery to bring back the essential movements in your hand.

There may be a bony block in the elbow which is not showing compete recovery too, though I can't comment exactly on that unless I see your X-ray. Do upload your Xray if possible so that I can comment on the prognosis and the next step which you need to take.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr.Aashish Raghu

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Aashish Raghu (8 hours later)
Thank you and I will attempt to send you images. though none have been taken in many months. Anyhow, you may be able to get and idea of the break.

thanks again.
XXXXXXX
doctor
Answered by Dr. Aashish Raghu (12 hours later)
Brief Answer:
Get well soon

Detailed Answer:
Awaiting the images.

Thanks and regards.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5334 Questions

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Suggest treatment for elbow stiffness

Brief Answer: Nerve grafting? Bone block can be considered Detailed Answer: Hi there, Thanks for the query. You have suffered a terrible elbow injury which now presents with its complications, one of which is the elbow stiffness. The physiotherapy needs to continue to try to improve the range of motion. The weakness is due to ulnar nerve injury. You can discuss with your Doctor about the potential of nerve grafting or tendon transfer surgery to bring back the essential movements in your hand. There may be a bony block in the elbow which is not showing compete recovery too, though I can't comment exactly on that unless I see your X-ray. Do upload your Xray if possible so that I can comment on the prognosis and the next step which you need to take. I hope I have answered your query. I will be available to answer your follow up queries. Regards, Dr.Aashish Raghu