Elbow Fracture Surgery for Seniors Coos Bay OR

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Richard Stephen Jany, MD
(541) 267-5151
1900 Woodland Dr
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: St Louis Univ Sch Of Med, St Louis Mo 63104
Graduation Year: 1982
Hospital
Hospital: Bay Area Hosp, Coos Bay, Or; Curry Gen Hosp, Gold Beach, Or
Group Practice: North Bend Medical Ctr

Data Provided By:
Anthony J Smith, MD
(541) 269-2445
200 Pierson Ln
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Columbia Univ Coll Of Physicians And Surgeons, New York Ny 10032
Graduation Year: 1952

Data Provided By:
Richard Stephen Jany
(541) 267-5151
1900 Woodland Dr
Coos Bay, OR
Specialty
Orthopedic Surgery

Data Provided By:
James A Holbert, MD
(541) 267-3578
2163 Koos Bay Blvd
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1953

Data Provided By:
Alan Lawrence Whitney, MD
(541) 266-3635
2699 N 17th St
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Md Sch Of Med, Baltimore Md 21201
Graduation Year: 1973

Data Provided By:
Curtis Dale Adams, MD
(541) 888-4099
2699 N 17th St
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Or Hlth Sci Univ Sch Of Med, Portland Or 97201
Graduation Year: 1962

Data Provided By:
Jon S Davis
(541) 267-5151
1900 Woodland Dr
Coos Bay, OR
Specialty
Orthopedic Surgery

Data Provided By:
Jon Steven Davis, MD
(541) 266-3600
2699 N 17th St
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1978

Data Provided By:
Michael Vincent McLean
(541) 266-3600
2699 N 17th St
Coos Bay, OR
Specialty
Orthopedic Surgery

Data Provided By:
Dara Parvin, MD
(541) 267-4429
1957 Thompson Rd
Coos Bay, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1993
Hospital
Hospital: Bay Area Hosp, Coos Bay, Or; Peace Harbor Hospital, Florence, Or
Group Practice: Oregon Coast Spine Institute

Data Provided By:
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Update on Surgical Treatment of Elbow Fractures in the Elderly

Fractures of the humerus (upper arm bone) just above the elbow are difficult to treat. Surgery is the standard way to treat these fractures. But the optimal approach isn't always clear at the out set. The surgeon must take into consideration many factors. How did it happen? What kind of break is involved? Are the soft tissues around the bone damaged in any way? Did the elbow joint surface crack in the process? How strong is the bone (i.e., does the patient have osteoporosis or brittle bones)?

The orthopedic surgeons who wrote this article are from the University of Maryland in Baltimore. They offer a review of the latest research in the area of distal humeral fractures. Distal is just another way of saying the break occurred at the bottom end of the bone.

Surgeons are seeing more of these injuries with the aging adult population in America. Most of these fractures occur in older adults with poor bone quality. That's one of the things that really makes surgery so difficult. Conservative (nonoperative) care is possible but only when the fracture is stable and can be immobilized in a cast or splint. That type of fracture isn't as common as the displaced (bones separate), comminuted (many tiny bone fragments) fractures that require surgery.

The surgical choices are usually: 1) internal fixation, 2) external fixation, and 3) total elbow replacement. Each of these choices has its own indications (when to use them), advantages, and disadvantages.

One of the ways surgeons have of evaluating which approach to use is to examine the results from other patients who were treated with one approach versus another. Outcome measures include elbow range-of-motion, return of normal muscle strength, function, bone healing, and quality of life. The joint should be stable yet move freely. Length of time in the hospital and in rehab along with the associated costs might also be factored in. Complications such as infection, poor wound healing, and nonunion (failure of the bone to heal) are recorded. Implant failure (usually from loosening) and revision surgery are two other possible problems that researchers keep track of as a way to evaluate the final results.

By reviewing all of the available research data, the authors were able to summarize what is known about each of these three surgical treatment approaches. Let's take a look at each one separately.

Internal Fixation. Internal fixation refers to an open procedure where the surgeon puts the bones back together and holds them in place with wires, metal plates, and/or screws. This is the most commonly used operation. Many decisions come into play with this approach. The surgeon sizes up the injury and decides how best to get into the joint: from the back of the elbow (posterior or from the sides? If it seems best to make the incision from the side, then which side: medial (side closest to the body) or lateral (side away from the body)?

Studies show that the posterior approach giv...

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