What is the elbow joint?

The elbow joint is the point where the arm meets the forearm. It is a complex joint as there are two joints within the same spot, that is, the joint between the humerus (arm) and ulna (one of the two forearm bones), as well as between the radius (the second forearm bone) and the humerus (arm).

The elbow joint is a synovial joint, meaning that it is enclosed by a fluidic capsule that helps to lubricate articulation. This capsule is medially and laterally thickened to create collateral ligaments, which works to stabilise the extending and flexing motions of the arm.

The elbow bursa is a membranous sac containing synovial fluid, which offset the friction caused by the articulation of the joint. The important bursae in the elbow joint are the intratendinous, subtendinous, and subcutaneous (olecranon).

The elbow’s joint capsule is also reinforced by a series of medial and lateral ligaments (annular ligament, ulnar collateral ligament, and radial collateral ligament).

Common Elbow Conditions And Injuries

The elbow is a common site for sporting injuries as well as fractures. These fractures are often challenging to put back together.

Our aim is to securely fix them so as to mobilise the elbow fast enough before stiffness sets in. Sometimes, in the older population, these fractures are not fixable, and we end up replacing part or the whole joint to restore early motion.

Arthritis is the second most common condition. This is managed firstly with non-surgical means, but failing this, an elbow replacement may be an option to restore mobility and reduce pain.

Although ligament injuries and dislocations are relatively uncommon, these are complex injuries to treat.

Common elbow injuries and conditions include:

  • Tennis elbow – Inflammation or tearing of tendons that connect the forearm muscles to the elbow.
  • Elbow contracture – Feeling of stiffness in the elbow that severely limits range of motion.
  • Elbow bursitis – Irritation or inflammation of the olecranon bursa that lubricates elbow articulation.
  • Bicep tendon tear at the elbow – Partial or complete tear (rupture) of the tendon connecting the bicep muscle to the elbow.
  • Triceps tendonitis – Inflammation or irritation of the tendon connecting the triceps to the humerus.
  • Elbow arthritis – Breakdown of cartilage that separates elbow bones, causing them to rub together and cause severe pain.
  • Ulnar nerve compression – Irritation or compression of the ulnar nerve that causes tingling, numbness, pain, and difficulty using fingers.
  • Elbow fracture – Partial or complete break in one of the bones that make up the elbow joint. Most often occurs in the ulna, as there is little tissue between it and the skin to absorb sudden impacts.

How Can An Elbow Injury Be Diagnosed?

The diagnosis is generally quite apparent on plain x-rays, but occasionally a CT scan or an MRI scan may be required for further clarity.

Other methods of diagnosing elbow injuries and conditions include electromyography and a biopsy of bursa fluid. A basic physical examination and check of your medical history may also be adequate to form a diagnosis.

What Are The Treatment Options For Elbow Injury?

A lot of the fractures around the elbow are important due to their proximity to the joint itself. That is, they most likely need operative treatment. It is important to distinguish simple dislocations from the more complex ones, where surgical input will help in early and long term results.

Arthritis is generally treated without an operation to begin with, using injections, pain medications and physiotherapy, failing which joint replacing procedures can be performed. Some contractures around the elbow are treated with keyhole surgery. The rehabilitation of such patients will need physiotherapy input.

Types of Shoulder Surgery

Elbow Replacement Surgery

Elbow replacement surgery involves damaged parts of the elbow joint being replaced with artificial components, known as prosthetics. An elbow replacement can be partial (in which only some parts of the joint are replaced) or total (meaning the whole elbow joint is replaced with a prosthetic).

Elbow Arthritis Surgery

There are several different procedures that can be used to treat arthritis in the elbow joint. These procedures include synovectomy, arthroscopic debridement, interpositional arthroplasty, and total elbow replacement.

Tennis Elbow Surgery

Tennis elbow surgery involves removing the damaged tendon to relieve pain and return full function to the joint. When the damaged part of the tendon is removed, the healthy part of the tendon is reattached to the bone. The surgeon may also remove a small piece of bone to improve blood flow and accelerate the healing process.

Elbow Contracture Release Surgery

Surgical treatment for elbow contracture is known as a capsular release and can be performed arthroscopically or via a large open incision. The surgery involves the release of the contracture that is causing stiffness in the elbow.

Ulnar Nerve Entrapment Surgery

Ulnar nerve release surgery involves the surgeon cutting and separating the ligament that is overlying the ulnar nerve. This creates more space in the ulnar tunnel, reducing the pressure on the ulnar nerve.

Elbow Surgery: FAQs

How long does elbow surgery take to heal?

For most surgical elbow treatments, the healing time takes between 6 to 8 weeks. The time it takes for your elbow to fully heal will depend on the complexity of the surgery you underwent and your commitment to post-operative care like physiotherapy. While healing can take a manner of weeks, getting full function back could take several months or longer.

What to expect after elbow surgery?

Based on the type of surgery you underwent, you may experience bruising and swelling following the procedure, but this can be controlled with medication and rest. You will generally be required to wait a few weeks before you can return to activities that activate your elbow joint. Ensure you check with your surgeon when it will be safe for you to start driving again and performing other activities.

What is the average cost of elbow surgery?

The amount you pay for elbow surgery will depend on the complexity of the procedure and your private health insurance. You could spend between $500 to $5000 depending on which surgery you undergo. Medicare can also help cover the costs of your elbow surgery.

Matthan Mammen
ELBOW, WRIST AND HAND SPECIALIST

Mr. Matthan Mammen

MS, FRACS (Orth)

Matthan is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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