Snapping elbow syndrome (Elbow Plica) - arthroscopic debridement

You or your child have just undergone surgical treatment for snapping elbow, also known as elbow plica syndrome, with Kemble. This condition is caused by a plica (a flap of unstable capsule or synovial fold) getting caught up in between the joint surfaces. This can lead to pain, catching, clicking, locking of the joint, or even a loud "snapping" sound as you move the elbow. 

Kemble has looked into you/your child's elbow with a telescope, and trimmed/thinned down this plica so that it will not cause catching or snapping. There will be several arthroscopic key-hole wounds which would have been closed with absorbable sutures. There will also be dermabond (skin glue), and dressings over the top. 

The following is a schematic diagram of a elbow plica causing irritation. 

Post operative recovery

General expectations and post-operative management

  • Most of the time, a plaster is not required. Some pain is to be expected. You will be given pain killers.

  • The elbow will be wrapped in a bulky bandage which will help protect the wound.

  • Your arm will be in a sling. This is for comfort only. You do NOT HAVE to use the sling and are in fact encouraged to come out of the sling frequently to move your elbow so it does not stiffen up. Try to do this at least 10 times a day.

  • Frequently move your fingers/thumb, even when you are in the sling 

  • Early numbness or tingling in the first couple of days following surgery is not uncommon. This may be due to the local anaesthesia Kemble placed into your wound to help with the pain, or due to the anaesthetic block the anaesthetist put in your shoulder area. 

  • Please do not lift anything heavier than a cup of tea at this time. 

  • Please keep your dressing/bandage dry at all times. You may use a plastic bag tied above the elbow to prevent the dressing/wound from getting wet during shower/bathing

  • The outer bandage can be removed at home after 3-4 days. There will be water resistant dressings underneathe which should remain intact until review with Kemble.

  • Between 10-16 days following surgery, you should have your wound checked. There may be sutures that need to be removed.

Therapy and movement

  • Starting immediately after surgery, It is important you come out of the sling to move your elbow. Bend and straighten your elbow all the way or as much as you can, and then hold it there for 10 seconds. Do 10 repetitions of this and do this 10 times a day (100 reps).

  • You can also start twisting your forearm such that the palm faces to the ceiling, the then twisting it the other way such that your palm faces the floor, all the while holding your elbow still by your side. These are called pronation and supination exercises. However, do not force this movement with the other hand or if there is pain until 4 weeks following surgery. 

  • Early movement is important so your elbow does not stiffen up, or so the pre-existing stiffness can go away as quickly as possible

  • Early movement may be uncomfortable or a little painful, however, it is important you still try to move it.

  • You should wean out of the sling over the next few days and be out of the sling altogether by the end of the first week after surgery. 

  • Most of the time, Kemble will organize for you to see a therapist to help with movement of the elbow and gradual strengthening. This should start within the first few weeks after surgery. 

  • At 4 weeks after surgery, can start passive supination and pronation exercises, as well as strengthening, with your therapist. 

Return to activity and sports

  • The speed of healing and return to sports is different for everyone. It is also dependent on your therapist's input.

  • Following surgery, you should limit weight-bearing to a "cup-of-tea" weight for the first 2 weeks.  

  • Once full range of motion or near full range of motion has been achieved, you may return to gentle sports training that does not involve throwing or weight-bearing of the arm. 

What to look out for

  • Continued drainage from the wounds that does not stop after 1 week

  • Suddenly deterioration in pain when previously pain has been improving

  • Sudden locking of the elbow and inability to bend/straighten

  • If any of the above is noted, please contact Dr Kemble Wang's team. 

©2020 Kemble Wang Orthopaedics

 

Disclaimer: All information provided on this webpage should be considered as general guidelines. Actual practice and (expected) outcomes may differ in your case. The contents has been created online for information purposes only. It is not intended to be a substitute for professional medical advice.