Dr. Betsy Nolan at the Oklahoma Shoulder Center treats patients with a range of elbow problems through outpatient surgical procedures. This may include the following injuries and procedures:
- Elbow arthroscopy (scope) procedures. Some examples include procedures to remove loose cartilage or bone fragments, treat tennis elbow, or resolve cartilage defects.
- Reconstructions for fractures or dislocations.
- Repair or reconstruction of torn ligaments. One example is ulnar collateral ligament reconstruction (commonly referred to as the Tommy Johns surgery, named after the famous baseball player who was the first to return to play following this procedure).
- Treatment of nerve entrapments. For example, ulnar nerve transposition can help treat cubital tunnel syndrome.
- Capsular releases to improve motion in a stiff elbow which has not improved with physical or occupational therapy.
As with any surgical procedure, it is important to follow the guidelines provided by your surgeon and the hospital related to preparing for and recovering from surgery. For outpatient elbow procedures, you will need someone to drive you to the hospital the morning of your procedure and drive you home afterward. It’s also generally a good idea to have someone stay with you the first night that you are home.
The length of time required for an outpatient elbow surgery will vary based on the procedure, but most procedures take around two hours or less. In most cases, elbow surgeries can be completed with a nerve block and sedation, rather than general anesthesia. Your anesthesiologist will discuss the options with you prior to surgery.
The nerve block puts part or all of your arm to sleep, which helps reduce pain both during and after surgery. Patients given a nerve block for surgery generally require less pain meds during and after surgery, and are therefore able to avoid many of the potential side effects of these medications. The nerve block will wear off at different times for different patients, but may last up to 48 hours, so we recommend that patients start taking their pain medicine before the block wears off and especially before going to sleep the night after surgery, in case the block wears off during the night. Once the nerve block wears off, you can determine how much pain medication you need, but it is generally easier to cut back the medication than try to “catch up” to the pain.
Depending on the type of surgery, you may be in a splint or sling or both for a short period. Elbow motion may be restricted, although to varying degrees depending on the type of operation, until your post-operative appointment with Dr. Nolan approximately two weeks after surgery. Some procedures, such as ulnar nerve transportation, don’t require any immobilization, while others may involve a specialized brace that only allows specific movements. Prior to your procedure, Dr. Nolan can discuss specifics for your elbow motion restrictions so that you can better prepare for the time after surgery.
The elbow area does not have much soft tissue padding around it, which means additional precautions may be needed during recovery to avoid movement or potentially bumping the elbow into a hard surface. In the days following surgery, you should not lift anything heavier than a coffee cup until cleared by Dr. Nolan. To reduce potential swelling, elevate your elbow above your heart and ice the elbow area.
Patients can generally remove the dressing on the wound after 48 hours — the easiest removal option is in a shower when the dressing is wet. You can wash with soap and water but avoid any lotions or creams. Also, use caution if out in the sun and keep your scar covered with clothing as sun exposure can cause the scar to spread.
We encourage patients to call our office with any questions before or after surgery. Give us a call at 405.278.8006. We’re here to help!
By Oklahoma Shoulder Center PLLC
May 3, 2017
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