The Elbow

Elbow dislocations are traumatic events, typically resulting from a significant fall on an outstretched hand. During a dislocation, the bones can move in various directions, with the ulna and radius most commonly shifting posteriorly from their normal positions.

Immediate Action: The priority in the event of an elbow dislocation is to relocate the elbow, as this quickly alleviates the substantial pain and improves mobility. Diagnosis is confirmed through an X-ray, and the successful relocation is also verified with an X-ray.

Treatment: Following relocation, the elbow is usually placed in a sling for a short period to allow initial healing. Physical therapy is essential afterward to help regain range of motion and strength.

Elbow dislocations can also cause additional injuries, such as fractures or tears to the major ligaments stabilizing the elbow. If these secondary injuries occur, surgery might be recommended to maintain the elbow's stability and function.

Medial and lateral epicondylitis are common causes of elbow pain in adults, often stemming from overuse injuries that lead to inflammation of the tendons in the elbow.

Medial Epicondylitis (Golfer’s Elbow): This condition involves inflammation on the inside of the elbow where the flexor tendons attach.

Lateral Epicondylitis (Tennis Elbow): This condition involves inflammation on the outside of the elbow where the extensor tendons attach.

These conditions frequently occur in people who participate in sports or activities requiring repetitive wrist flexion and extension, such as tennis, golf, bowling, or weightlifting.

Symptoms:

• Generalized elbow pain, which is exacerbated by wrist and forearm motion and gripping.
• Pain typically starts during repetitive activities but can progress to discomfort during daily tasks.

Diagnosis:

• Primarily through a physical examination and X-ray.
• MRIs are not usually necessary.

Treatment:

• Initial Steps: Rest from the activity causing the pain, use of anti-inflammatory medications, and physical therapy.
• Persistent Symptoms: In cases where initial treatments are not effective, a corticosteroid injection may be recommended.

Resting from aggravating activities, combined with targeted physical therapy, typically resolves the majority of cases.

The biceps and triceps muscles have distal tendons that attach to the elbow. While rare, these tendons can tear during injuries involving excessive tension during elbow flexion or extension.

Symptoms:

• A popping sound at the time of injury.
• Immediate pain in the elbow joint.
• Swelling, weakness, and reduced range of motion following the injury.

Diagnosis:

• A physical examination to test strength and check for associated fractures using X-rays.
• An MRI is essential to confirm the extent of the tendon tear.

Treatment:

• Initial Evaluation: It is crucial to have these injuries assessed by a surgeon.
• Approach: Treatment varies based on factors such as age, activity level, and the severity of the tear. Both surgical and non-surgical options are considered.
• Non-Surgical Treatment: May involve a brief period of immobilization in a sling, followed by physical therapy focusing on restoring range of motion and strength.
• Surgical Treatment: Surgical repair of the tendon might be recommended to regain full strength and return to previous activity levels.

If you're experiencing elbow pain or suspect a tendon tear, don't hesitate to seek professional advice. Contact Wiki Wiki Orthopedics in Hawaii or use the online booking tool to schedule an appointment.

Cubital tunnel syndrome involves the compression and inflammation of the ulnar nerve, which runs along the inner side of the elbow, through the forearm, and into the hand. This nerve provides sensation and strength to the ring and little fingers.

Symptoms:

• Numbness and tingling in the ring and little fingers.
• Worsening symptoms at night when sleeping with the elbow bent or during repetitive upper extremity activities.
• Symptoms typically start mildly but can progress to weakness in the hand or fingers if left untreated.

Diagnosis:

• Primarily through a physical examination, supplemented by a nerve conduction study.

Treatment:

• Conservative Approach: In mild cases, treatment involves anti-inflammatory medication, activity modification, and splinting the elbow in extension at night.
• Surgical Option: Severe cases may require ulnar nerve transposition surgery.

If you're experiencing symptoms of cubital tunnel syndrome, it's important to seek professional evaluation. Contact Wiki Wiki Orthopedics in Hawaii for an assessment and appropriate treatment recommendations.