Elbow Fracture Surgery for Seniors Kapolei HI

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Neil Thos Katz, MD
(808) 689-9055
91-896 Makule Rd Ste 103
Ewa Beach, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Tufts Univ Sch Of Med, Boston Ma 02111
Graduation Year: 1981

Data Provided By:
Steven T Tottori, DDS
(808) 955-1226
525 Farrington Hwy Ste 104
Kapolei, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Mark K Kitamura, DDS
(808) 456-5537
850 Kamehameha Hwy Ste 215
Pearl City, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Terry Alan Vernoy, MD
(808) 533-3393
98-1079 Moanalua Rd
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduation Year: 1978

Data Provided By:
Gregory Henkuo Chow, MD
98-1079 Moanalua Rd
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Duke Univ Sch Of Med, Durham Nc 27710
Graduation Year: 1988

Data Provided By:
Wiley Brunel
(808) 678-2211
91-2139 Fort Weaver Rd Ste 208
Ewa Beach, HI
Specialty
General Surgery, Hand Surgery

Data Provided By:
Howard Teruo Fujino, DDS
(808) 677-9741
94-873 Farrington Hwy
Waipahu, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
James Kenneth Cole, MD
(808) 206-8231
101B Beard Ave
Honolulu, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: E Tn State Univ J H Quillen Coll Of Med, Johnson City Tn 37614
Graduation Year: 1994
Hospital
Hospital: Freeman Hosp -West, Joplin, Mo; St Johns Reg Medctr, Joplin, Mo
Group Practice: Midwest Orthopaedic Surgery

Data Provided By:
Alan S T Chang, DDS
(808) 487-2411
98-1247 Kaahumanu St Ste 202
Aiea, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Masao Takai, MD
(808) 488-1665
99-128 Aiea Heights Dr Ste 705
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kyoto Prefectural Med Coll, Kamikyo-Ku, Kyoto, Japan
Graduation Year: 1966

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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