Elbow Fracture Surgery for Seniors Lincoln NE

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Robert Wayne Dugas, MD
(402) 488-3322
575 S 70th St Ste 200
Lincoln, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: La State Univ Sch Of Med In New Orleans, New Orleans La 70112
Graduation Year: 1983
Hospital
Hospital: St Elizabeth Comm Hlth Center, Lincoln, Ne
Group Practice: Nebraska Orthopaedic Assoc

Data Provided By:
Jackson Junior Bence, MD
(402) 489-3802
600 S 70th St Ste 597
Lincoln, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1958
Hospital
Hospital: Veterans Affairs Med Ctr, Lincoln, Ne
Group Practice: VA Medical Ctr

Data Provided By:
William Francis Garvin
(402) 488-3322
575 S 70th
Lincoln, NE
Specialty
Hand Surgery

Data Provided By:
Reed Bartz, MD
(303) 441-2219
575 S 70th St Ste 200
Lincoln, NE
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Jeffrey C Nickel, DDS
(402) 472-1307
Unmc 40Th & Holdredge
Lincoln, NE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert W Glenn, DDS
(402) 488-5275
1630 S 70th St Ste 202
Lincoln, NE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Douglas A Koch
(402) 436-2000
6900 A St
Lincoln, NE
Specialty
Orthopedic Surgery, Foot & Ankle Surgery, Sports Medicine

Data Provided By:
Donald Joseph Walla, MD
(402) 488-3322
575 S 70th St Ste 200
Lincoln, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1977

Data Provided By:
Douglas P Tewes
(402) 436-2000
6900 A St
Lincoln, NE
Specialty
Orthopedic Surgery, Sports Medicine

Data Provided By:
Dr.Keith Lawson
(402) 436-2000
6900 A St # 200
Lincoln, NE
Gender
M
Education
Medical School: Univ Of Ne Coll Of Med
Year of Graduation: 1996
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

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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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