Elbow Fracture Surgery for Seniors Maryland Heights MO

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Robert A Shively, MD
(314) 652-4100
915 N Grand Ave
Saint Louis, MO
Business
Washington University Orthopedics
Specialties
Orthopedics

Data Provided By:
Tony Heng-Chi Hsu, DDS
(314) 344-1121
2388 Schuetz Rd Ste 3A-55
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Dr.William Schroer
(314) 291-3399
12266 De Paul Dr # 220
Bridgeton, MO
Gender
M
Education
Medical School: Washington Univ Sch Of Med
Year of Graduation: 1989
Speciality
Orthopedic Surgeon
General Information
Hospital: Depaul
Accepting New Patients: Yes
RateMD Rating
4.3, out of 5 based on 3, reviews.

Data Provided By:
Ronald Earl Palmer, MD
(309) 676-5546
12303 de Paul Dr
Bridgeton, MO
Gender
Male
Education
Medical School: Finch U Of Hs/Chicago Med Sch, North Chicago Il 60664
Graduation Year: 1975
Hospital
Hospital: St Francis Med Ctr, Peoria, Il
Group Practice: Orthopedic Institute Of Illinois

Data Provided By:
Gary Farley, DO
(314) 837-5555
12277 de Paul Dr Ste 100
Bridgeton, MO
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1977
Hospital
Hospital: Depaul Health Center, Bridgeton, Mo
Group Practice: Mid America Orthopedic Surgery

Data Provided By:
Osmond G Jones, DDS
(314) 344-1121
2388 Schuetz Rd
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
E Glenn Glassman, DDS
(314) 739-8888
2388 Schuetz Rd Ste A55
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Jacques Simon Van Ryn, MD
(314) 291-3399
12277 de Paul Dr Ste 305
Bridgeton, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Albany Med Coll, Albany Ny 12208
Graduation Year: 1979

Data Provided By:
Dennis J Brady, DDS
(314) 739-3163
12139 Natural Bridge Rd
Bridgeton, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Gary Lester Singer, MD
12277 de Paul Dr
Bridgeton, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Cincinnati Coll Of Med, Cincinnati Oh 45267
Graduation Year: 1970

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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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