Open reduction internal fixation (ORIF) of elbow fracture

You or your child have just undergone fixation of an elbow fracture with Kemble. This could be done with either screws, plates, anchors, or a combination of these. The elbow is composed of 3 bones - the bottom end of the humerus, and the top ends of the radius and ulna. One or more of these bones could have been broken and fixed. 

You will have one or more incisions on your elbow through which the work was done. These would be on either the inside or outside of your elbow. The incisions will have sutures holding it closed. These would be dressed with water resistant dressing, on top of which bandage would have been applied. There is typically no plaster used.

The following is an example of an elbow that was fixed using screws.

  • Postoperatively your arm will be in a sling. Typically, you can start coming out of the sling straight away with the physiotherapist for exercises. When not doing your exercises, please remain in the sling until Kemble lets you know you can come out of it.

  • It is normal to have some tingling or numbness or weakness following your procedure. This is often due to a nerve block performed preoperatively to help with your pain, or with postoperatively injected local anaesthesia. This will wear off in the first day or two.

  • It is very important post-operatively that you work with your therapist in trying to regain motion. Once Kemble gibve the ok, you will need to gently start moving your elbow straight-away to get the best result

  • 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 showering/bathing

  • The outer bandage around your elbow may be removed after 3-4 days. There will still be water resistant dressing underneath - please leave these intact until you see Kemble again.

Therapy and movement

  • Once given the OK by Kemble, it is important you come out of the sling to try to move your elbow. Bend and straighten your elbow all the way or as much as you can. Do 10 repetitions of this and do this 10 times a day (100 reps)

  • Moving the elbow may be uncomfortable or a little painful, however, it is important you still try to move it.

  • 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 week after surgery. 

  • In some broken elbows, Kemble may have had to repair ligaments in the elbow as part of the repair process. This may involve the lateral ligament (LUCL) or the medial ligament (MCL). If this was done, weaning process out of sling will be slower, and you may be instructed to perform exercises while lying on your back, bending your elbow with your arm above your head (supine overhead elbow flexion/extension exercises).

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 6 weeks. 

  • Speed of bone healing is different for everyone. This may occur between 6 weeks and 4 months following surgery, depending on your age and the exact break pattern. Sometimes the bones may not heal until even later.

  • Bone healing is usually determined on xray, and Kemble will advise you when there is sufficient healing to progress with your activities.

  • Once sufficient bone healing has occurred, you could then increase weight-bearing of the arm, and gradually return to sports.

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 Kemble'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.