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Suggest Treatment For Fracture Of Olecranon Of Left Elbow

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Posted on Tue, 3 Mar 2015
Question: my mother, 60 yrs, had an accident and had her olicranon fractured in left hand elbow and gone apart.
she had undergone an surgery named "ORIF with 2k wires and TBW"(looks just like the picture attached) 6 days ago.
My question is-
1) whether this is the best option?
2)how much time it will take to heal completely?
3)whether she will be able to move her hand complete 180 degree?
with regards,
-XXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (58 minutes later)
Brief Answer:
This is best option.

Detailed Answer:
Hi,
Thanks for choosing healthcaremagic for posting your query

I'm Dr. Sudhir Kumar,

I have gone through your question in detail and understand your concern.
Your mother got accident and she got fracture of Olecranon of left elbow and was operated by ORIF with 2K wires and TBW. Answer to your questions are:-

1.This is best option.
2.Complete healing may take nearly 3Months.
3.She will be able to move her elbow complete 180 degrees.But she has to do mobilization exercises of elbow joint for it.

You can discuss with your treating Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Sudhir Kumar (8 days later)
Thank you sir for your answer. I am reopening the case as my mother is facing some problems.
The day before yesterday her stitches has been removed.After that the same day physiotherapy has been started and an elbow support from OPPO is given.
But after that there has been some swelling which is noticeable.
Also she is feeling it tough to move the hand.
What is the problem or is it normal?
Either case please elaborate.
With regards,
-------XXXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (21 minutes later)
Brief Answer:
Some swelling at operative site is expected.

Detailed Answer:
Hi

Welcome back

I have gone through your question and follow up question in detail and understand your concern.

Some swelling at operative site and distal to it is expected. At this stage she will have some movements at elbow joint and movements will increase gradually with mobilization exercises. She can start using hand in light works. Whether she is having difficulty in moving hand means she is difficulty in moving wrist and fingers or you mean difficulty in moving at elbow joint. Difficulty at movements at elbow is expected but movements at wrist and finger joints are expected to be normal.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Sudhir Kumar (21 minutes later)
Thank you sir.
there is no such pain in moving wrist and fingers. But there is also pain when she is reverting her palm face from upside to down.
please comment on that.
Further, how the elbow support is beneficial?
And after how many days she is expected to get relieve from the pain in moving her hand?
with regards,
---------XXXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (1 hour later)
Brief Answer:
Pain should be much less after 3 weeks.

Detailed Answer:
Hi

Welcome back

I have gone through your question and follow up question in detail and understand your concern.

Some pain is expected. Pain in wrist,hand and fingers is due to stiffness due to lack of excercises. Pain at elbow will be due to operation and it is likely to be much less with mobilisation excercises. I expect pain and elbow to be much less after 21 days.Pain when she is reverting her palm face from upside to down is likely to be due to operation and will be much less with mobilisation excercises of elbow and wrist.

Elbow splint is useful in reducing swelling and pain at elbow. But she should be encouraged to remove splint several times a day and do mobilisation excercises of elbow . She should be encouraged to use elbow and hand in light day to day activities.

You can discuss with your Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Sudhir Kumar (3 days later)
Thank you sir for the detailed answer.
One more update-The swelling has been reduced slightly but the portion of the hand that extends from elbow to wrist (olicranon ? ) is slightly been hard.
I would like to get your opinion.
With regards,
-------XXXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (35 minutes later)
Brief Answer:
Some hardness in the area around the operation is expected .

Detailed Answer:
Hi

Welcome back

I have gone through your question and follow up question in detail and understand your concern.

Some hardness in the area around the operation is expected (elbow to wrist is expected). She should do mobilisation excercises of elbow to reduce swelling and she should be encouraged to use her elbow and hand as far as possible in day to day activities to recover early. She can take analgesic such as ibuprofen for pain relief.

You can discuss with your Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Sudhir Kumar (3 days later)
Good evening sir.
I am reopening the last case of my mother i.e Olecranon fracture and successive operation "ORIF with 2-K wires and TBW".
Recall: operation on 04/01/2015
stitch removal on 17/01/15
today it is 26/01/15.
doctor suggested ROM exercises.

1)Will you please advice how much pressure she should apply in doing exercises for both extension and flexion-i mean upto how much degree she should target.
2)How much time it may take to rejoin the fragments(single transverse fragment)
with regards,
-----------XXXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (1 hour later)
Brief Answer:
She should apply as much pressure as she can apply actively.

Detailed Answer:
Hi

Welcome back

I have gone through your question and follow up question in detail and understand your concern.
1.She should apply as much pressure as she can apply actively(by injured limb) in both extension and flexion and should target as much as she can reach maximum increasing daily. She should not use passive force(by uninjured hand or by other person.)
2.Rejoining of fragment may take nearly 3 months.

Other matter already discussed.

You can discuss with your Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Sudhir Kumar (29 minutes later)
Thank you sir.
1)My doubt is that whether the TBW will loosen and thereby dispositioning the two parts by giving extra tension or not?---------if you explain please.
2)Whether and early when the hardwares can be removed ?
with regards
---------------XXXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (41 minutes later)
Brief Answer:
TBW will not loosen by excercises.

Detailed Answer:
Hi

Welcome back

I have gone through your question and follow up question in detail and understand your concern.
1.No TBW will not loosen.Exercises are recommended from day one .Now 3 weeks already passed.
2.Hardware can be removed as soon bone unites.It is generally removed when fracture line become invisible on x rays.

Other matter already discussed.

You can discuss with your Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Sudhir Kumar (15 days later)
Good evening sir.
I am back with the case of my mother.
It is now 1 month and 1 week over the operation is done(ORIF with 2 K wires and TBW).
The pain is now slightly reduced. But there is considerable amount of swelling over the whole region from(and around) elbow to palm(back side).
Yesterday one X-Ray done-shows bones and hardwares intact and well positioned.
Now she is not using any support for that hand.
What can be the possible reasons of the swelling?
Whether any infection is there-how to diagnose?

with regards,
-------XXXXXX XXXXXXX
doctor
Answered by Dr. Dr. Sudhir Kumar (1 hour later)
Brief Answer:
She should do mobilisation excercises .

Detailed Answer:
Hi

Welcome back

I have got through your question and follow up questions and understand your concern.
Most likely cause of swelling is excercises less and keeping limb dependant (lowered). Infection can also be cause. Signs of infection is swelling specially if it is fluid like (fluctuate), warm local area, pain and fever. Pus discharge is another sign. On laboratory examination ESR will be high, C reactive protein will be high and total leucocyte count will be high.
Now it is advisable to use her arm in all activities and She should do mobilisation excercises as much as she can. She can take analgesic such as ibuprofen for pain relief.

You can discuss with your Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing your mother a good health.

Take care.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Dr. Sudhir Kumar

Orthopaedic Surgeon

Practicing since :1993

Answered : 3356 Questions

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Suggest Treatment For Fracture Of Olecranon Of Left Elbow

Brief Answer: This is best option. Detailed Answer: Hi, Thanks for choosing healthcaremagic for posting your query I'm Dr. Sudhir Kumar, I have gone through your question in detail and understand your concern. Your mother got accident and she got fracture of Olecranon of left elbow and was operated by ORIF with 2K wires and TBW. Answer to your questions are:- 1.This is best option. 2.Complete healing may take nearly 3Months. 3.She will be able to move her elbow complete 180 degrees.But she has to do mobilization exercises of elbow joint for it. You can discuss with your treating Doctor about it. Hope I have answered your query. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: https://www.bit.ly/askdrsudhirortho Wishing your mother a good health. Take care.