The Elbow Center

Cubital Tunnel Release and Ulnar Nerve Transposition in Wayne & Paramus, NJ

A surgical release of the ulnar nerve within the cubital tunnel.

A cubital tunnel release with or without ulnar nerve transposition is the surgical treatment for cubital tunnel syndrome. This may be considered if a patient has persistent symptoms and dysfunction despite conservative management. The patient’s symptoms of numbness, tingling and sometimes weakness are a result of excess pressure on the ulnar nerve. The surgery involves decompressing the ulnar nerve from a tight tunnel of tissue that is putting pressure on the nerve. Sometimes an ulnar nerve transposition may also be done to move the nerve into a less vulnerable position. The surgery involves an incision over the inside of the elbow. The patient is generally placed in a soft dressing after surgery and recovery is usually two to three weeks to allow the incision to fully heal. At this point, you can return to activities as tolerated. If the nerve compression was severe, the recovery of sensation may take several months to a year.

Distal Humerus ORIF in Wayne & Paramus, NJ

Surgical fixation of humerus fractures near the elbow with plates and screws.

Distal Humerus ORIF (Open Reduction Internal Fixation)
Distal humerus fractures often have to be treated surgically with plates and screws that are fixated to the bone to stabilize the fracture. Depending on the location and type of fracture, more than one plate may be used on either side of the bone. Early guided range of motion may be encouraged to prevent stiffness. X-rays will be taken at follow-up appointments to ensure proper healing and maintained alignment. The bone will usually take four to six weeks to heal, but the rehab process will take several months.

Elbow Contracture Release in Wayne & Paramus, NJ

Surgical removal of soft tissue or loose bodies that block motion and cause pain at the elbow.

When an elbow contracture cannot be treated conservatively, surgical management may be indicated for a patient to regain motion and function of the elbow. This can be done through an open or arthroscopic approach. In either case, it involves removing soft tissue, synovitis and possibly loose bony fragments that may be blocking motion and causing pain. Physical therapy and bracing are a crucial part of the recovery process and generally begin immediately after surgery to retain the motion that was gained from the surgery.

Open Elbow Reduction in Wayne & Paramus, NJ

An open surgical reduction of elbow dislocations.

An open elbow reduction is usually reserved for an elbow dislocation that may be complicated by concomitant fractures or unstable reduction. Extensive soft tissue and ligamentous injury may also need to be addressed during surgery as well as any bony loose bodies or fractures. Generally, motion will begin within a few days after surgery with a therapist and a specific protocol to avoid stiffness.

Supracondylar/Condylar CRPP in Wayne & Paramus, NJ\

Elbow fractures treated with wires and screws in addition to a cast.

Supracondylar/Condylar CRPP (Closed Reduction Percutaneous Pinning)

If a pediatric elbow fracture is displaced, surgery may be recommended to realign the bone and hold it in place with wires or screws in addition to a cast. The patient would then be followed closely in the office with serial x-rays to ensure bone alignment is maintained. Wires that are used to help realign the bone are typically removed in the office several weeks after surgery. If screws are utilized, sometimes these will need to be removed several months later with an additional surgery to allow for continued bone growth. Children generally regain their motion and strength without therapy, but in some cases physical therapy may be utilized.

Extensor Carpi Radialis Brevis Debridement (PRP Injection) in Wayne & Paramus, NJ

Platelet-rich plasma or PRP injections involve injecting the patient’s own platelets at a high concentration into the site of the tendon injury to promote further healing.

PRP injection

Some patients have persistent lateral epicondylitis (tennis elbow) despite conservative management. In these cases, further treatment is indicated. Platelet-rich plasma or PRP injections involve injecting the patient’s own platelets at a high concentration into the site of the tendon injury to promote further healing. This treatment may be a good initial option prior to pursuing a more invasive surgical intervention. PRP injections are less invasive and can be done in the office. It is important to keep in mind that it may take several rounds of injections for patients to notice an improvement in their symptoms.

Extensor carpi radialis brevis debridement

When other treatment options are unsuccessful, surgical intervention is indicated. This usually involves debridement of the contributing ECRB tendon. The tendon debridement may be done with a small incision directly over the area or arthroscopically with a camera introduced into the elbow joint. In either case, the ECRB tendon is identified and debrided (devitalized or frayed tissue is removed) to promote healing and decrease pain. The patient is usually placed in a soft dressing postoperatively and begins elbow range of motion right away. The patient is usually able to return to most activities within three to four weeks.

Radial Tunnel Release in Wayne & Paramus, NJ

This surgery involves an incision over the dorsal forearm and dissection down to the level of nerve compression.

A radial tunnel release is done when symptoms persist despite conservative management. This surgery involves an incision over the dorsal forearm and dissection down to the level of nerve compression. The supinator muscle and other structures overlying the nerve are incised and the posterior interosseous nerve is decompressed. This should give the patient relief of their symptoms, and they will regain normal function of their arm in two to three weeks once the incision has fully healed.

Radial Head Arthroplasty in Wayne & Paramus, NJ

Replacement of the radial head with prosthetic hardware.

A radial head arthroplasty is done when a radial head fracture is comminuted and therefore an open reduction and internal fixation (ORIF) is not possible. Many times, this type of fracture is associated with an elbow dislocation. The surgery involves removing the radial head and portion of the radial neck and replacing it with a prosthetic radial head. Postoperative recovery will involve therapy to regain motion and strength. Generally, physical therapy begins shortly after surgery.

Olecranon ORIF in Wayne & Paramus, NJ

An incision is made directly over the fracture, and the bones are placed back into anatomic alignment and secured with a plate and screws or a tension band wire construct.

Olecranon ORIF (Open Reduction Internal Fixation)

Surgical intervention may be necessary to ensure healing and return to function following an olecranon elbow fracture. This is usually a same-day procedure that is done at a hospital or surgery center. An incision is made directly over the fracture, and the bones are placed back into anatomic alignment and secured with a plate and screws or a tension band wire construct. It will take four to six weeks for the fracture itself to heal, but early elbow range of motion will be encouraged to prevent stiffness. Physical therapy will likely be a part of the rehabilitation process to help regain motion and strength.