Elbow Fracture Surgery for Seniors Los Lunas NM

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William B Pratt, MD
(505) 869-4212
Bosque Farms, NM
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Frank Hamilton Peacock, DDS
(505) 452-8633
2127 Los Padillas Rd Sw
Albuquerque, NM
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Lorene S Valdez Boyle, MD
800 Paseo Bueno Ct SW
Albuquerque, NM
Gender
Female
Education
Medical School: Univ Of Nm Sch Of Med, Albuquerque Nm 87131
Graduation Year: 1999

Data Provided By:
Frank G Hesse, MD FACS
(505) 265-3031
PO Box 9528
Albuquerque, NM
Gender
Male
Education
Medical School: State Univ(syracuse)
Graduation Year: 1954

Data Provided By:
James Francis Fahey Jr, MD
(505) 272-4107
2211 Lomas Boulevard North East,
Albuquerque, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduation Year: 1970

Data Provided By:
John Charles France, MD
(304) 535-6343
3436 Isleta Blvd SW
Albuquerque, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Pittsburgh Sch Of Med, Pittsburgh Pa 15261
Graduation Year: 1986

Data Provided By:
Paul Lesko, MD
Albuquerque, NM
Specialty
Orthopaedic Sugeon

Data Provided By:
Jean Evelyn Wright, MD
(505) 262-7281
3621 Camino Alameda SW
Albuquerque, NM
Gender
Female
Education
Medical School: Univ Of Mi Med Sch, Ann Arbor Mi 48109
Graduation Year: 1970

Data Provided By:
Anthony F Pachelli, MD
(505) 724-4300
201 Cedar St SE
Albuquerque, NM
Business
New Mexico Orthopaedic Associates
Specialties
Orthopedics

Data Provided By:
Michael Sumner Mitnik, MD
(505) 893-2880
4801 McMahon Blvd NW Ste 155
Albuquerque, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mt Sinai Sch Of Med Of The City Univ Of Ny, New York Ny 10029
Graduation Year: 1979
Hospital
Hospital: St Joseph Rehabilitation Ctr, Albuquerque, Nm
Group Practice: Southwest Orthopaedic Specs

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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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