treatment for elbow fracture

suzanne4, RN · May 13, 2004

Had he had a follow-up recently with an orthopedic surgeon? Was he ever seen by one at the time of the injury? Does he have any ligament involvement? Or has he been checked for that?

got2luvnights · May 17, 2004

Had he had a follow-up recently with an orthopedic surgeon? Was he ever seen by one at the time of the injury? Does he have any ligament involvement? Or has he been checked for that?

He was treated in the ER in April by several closed reduction attempts which resulted in ORIF with pins. These were removed in the OR 2weeks post-op and the arm was frozen at a 90 degree angle. 2 different type Jaz splints were used 4hours a day for 4 months with some benefit to extension but none in other directions. During this time he also showed severe signs of ulnar neuropathy and clawing of the hand. This was confirmed in June on a EMG and NCS which said he had severe axonal degeneration and it was suggested that a sural nerve graft may be needed. In August a neurolysis and sub-muscular transposition of the ulnar nerve was performed which restored feeling yet the atrophy was severe. In the begining he was followed several times a month for the first 6months then every month following. He also was seen by OT 3xwk for 6 months. I was never told of any ligament damage however I can not imagine that there was not some. How can that be checked now if there was damage and what can be done. He is due to have reconstuctive work done in July to help restore flexion/extension. The doc feels that supination will likely be a permanent disability. This is hard to believe that there is not some kind of surgery out there so my son could be able to turn a doorknob again among many other things. If you have any information it would be greatly appreciated. We have another appt. at the end of May. Have your ever dealt with this type of injury before.

Thank you very much for responding.

suzanne4, RN · May 17, 2004

Not sure what city that you live in, but I would definitely get a second opinion and by someone that specializes in trauma orthopedics, and possibly even a burn specialist, as they deal with a lot of frozen joints, especially elbows due to the nature of burns.

How did your son injure the elbow to begin with? Was it bicycle related by any chance?

got2luvnights · May 17, 2004

Not sure what city that you live in, but I would definitely get a second opinion and by someone that specializes in trauma orthopedics, and possibly even a burn specialist, as they deal with a lot of frozen joints, especially elbows due to the nature of burns.
How did your son injure the elbow to begin with? Was it bicycle related by any chance?

He is being followed by a pediatric orthopedic upper extremity microvascular specialist. He fell off while swinging on a swing set which was very low to the ground. He hit the grass and had no scrapes on the elbow. His first surgeon was a peds ortho then we saw 2 hand specialist who wanted to take the wait and see approach in regards to his nerve damage no one wanted to believe that the nerve was damaged to such a degree. That is when I took him to see the specialist who is treating him now. I trust him completly however the need to supinate ones hand and arm is a very important skill that is needed. He said the problem could be in the wrist, interousous membrane and or elbow joint. and the surgery to attempt to fix this supination would require opening the palm of his hand and past his elbow. The risks of developing additional contractures is very high in this surgery.

suzanne4, RN · May 17, 2004

Sorry that you and your son are going thru all of this. Do not knowof anything else to suggest at this point. But if I come across anything, I promise to let you know.

Good luck and give your little one a hug for me........... :balloons: