Elbow Fracture Surgery for Seniors Peru IN

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William Hugo Pohnert, MD
(765) 472-8041
285 W 12th St Ste 106
Peru, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mi Med Sch, Ann Arbor Mi 48109
Graduation Year: 1967
Hospital
Hospital: Howard Comm Hosp, Kokomo, In; St Joseph Mem Hosp, Kokomo, In; Dukes Mem Hosp, Peru, In; Healthsouth Rehabilitation Hos, Kokomo, In
Group Practice: Northcentral Indiana Ortho

Data Provided By:
Charles Edward Montgomery, MD
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 1969

Data Provided By:
Jeffrey F Granger
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialty
Orthopedic Surgery

Data Provided By:
Charles E Montgomery
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialty
Orthopedic Surgery

Data Provided By:
Jeffrey Dean Yoder
(765) 868-0313
1907 W Sycamore St
Kokomo, IN
Specialty
Orthopedic Surgery

Data Provided By:
Aijaz Mohammed Mirza, MD
(260) 569-2408
710 N East St
Wabash, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Dow Med Coll, Univ Of Karachi, Karachi, Pakistan
Graduation Year: 1958
Hospital
Hospital: Wabash County Hosp, Wabash, In
Group Practice: Mirza Orthopedics

Data Provided By:
Jeffrey Francis Granger, MD
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Chicago, Pritzker Sch Of Med, Chicago Il 60637
Graduation Year: 1981

Data Provided By:
Jesse Lee Sandlin, MD
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Northeastern Oh Univs Coll Of Med, Rootstown Oh 44272
Graduation Year: 1994

Data Provided By:
Kevin T Jarrell, DDS
(765) 453-4261
3905 Southland Ave # A
Kokomo, IN
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Thomas M Reilly
(765) 236-8700
311 S Berkley Rd
Kokomo, IN
Specialty
Orthopaedic Surgery of the Spine

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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