Procedures
Elbow Arthroscopy
Elbow arthroscopy, also referred to as keyhole or minimally invasive surgery, is a surgical procedure that is performed through tiny incisions to evaluate and treat several elbow conditions.
Ulnar Nerve Neuropathy
Ulnar nerve neuropathy is the entrapment or compression of the ulnar nerve causing impairment of its function. The branches from the spinal nerve C8 (cervical) and T1 (upper thoracic) give rise to the ulnar nerve that passes close to the ulna bone of the forearm.
Ulnar Nerve Release
Ulnar nerve release, also known as ulnar nerve decompression, is a surgical procedure to treat a medical condition called ulnar nerve entrapment.
Elbow Ligament Reconstruction
Ligament reconstruction is considered in patients with ligament rupture. Your surgeon will make an incision over the elbow. Care is taken to move muscles, tendons, and nerves out of the way. The donor's tendon is harvested from either the forearm or below the knee.
Distal Biceps Repair
Distal biceps repair is a surgical procedure to restore a ruptured or torn distal biceps and tendon, caused by an injury.
Open Elbow Surgery
Open elbow surgery is an operative procedure performed to treat certain conditions of your elbow through a large, open cut (incision) in the skin using a scalpel.
Golfer's Elbow Surgery
Golfer’s elbow is a condition associated with pain on the inside of the elbow where tendons of your forearm attach to the bony prominence (medial epicondyle). It is also called medial epicondylitis and is caused by injury or irritation to the tendons which can become painful and swollen.
Tennis Elbow Surgery
Tennis elbow is a common name for the elbow condition lateral epicondylitis. It is an overuse injury that causes inflammation and microtears of the tendons that attach to the lateral epicondyle.
Elbow Tendon and Ligament Repair
Tendon debridement: This procedure is commonly used in the management of tendinitis. In this procedure, your surgeon removes any damaged tissue and cleans the tendon.
Ulnar Nerve Transposition
The ulnar nerve is one of the 3 main nerves in the arm that travels down from the neck through a bony protuberance inside the elbow (medial epicondyle), under the muscles of the forearm and down the hand on the side of the palm, towards the little finger.
Malunion Surgery (Elbow)
Malunion, also known as crooked healing, is the failure of a fractured bone to rejoin properly due to poor alignment of the fracture fragments. The condition results in abnormality and deformity of the bone (bent or twisted bone).
Common Extensor Tendon Origin Repair
The common extensor tendon is a tough band of fibrous connective tissue that attaches to the lateral epicondyle of the humerus (long bone in the upper arm) at the elbow. Rupture or tear of the common extensor tendon is the most common acute tendon injury of the elbow.
ORIF of the Humerus Fractures
A humerus fracture is a condition that occurs when there is a break in the humerus or upper arm bone that commonly occurs as a result of severe trauma. Fracture of the humerus can affect the movement and function of your arm as well as your work and activities of daily living.
ORIF of the Coronoid Fractures
Coronoid fractures are a break in the coronoid process of the ulna due to trauma or injury. A coronoid fracture of the ulna is a complex intraarticular fracture that is difficult to expose due to complex surrounding anatomical structures.
Elbow Fracture Reconstruction
Elbow fracture reconstruction is a surgical procedure employed to repair and restore the appearance and full function of a damaged elbow caused by severe trauma or injury. This may include repairing damaged structures or replacing missing or damaged structures with adjoining skin, muscles, ligaments, tendons, bones, or nerves to restore the appearance and function.
Cubital Tunnel Release (Medial Epicondylectomy)
Cubital tunnel release is a surgical procedure to correct cubital tunnel syndrome. Cubital tunnel syndrome is a condition characterized by compression of the ulnar nerve in an area of the elbow called the cubital tunnel.
ORIF of the Distal Humerus Fractures
A distal humerus fracture is a condition that occurs when there is a break in the lower end of the humerus bone that commonly occurs as a result of severe trauma. Fracture of the distal humerus can affect the movement and function of your arm as well as your work and activities of daily living.
ORIF of the Olecranon Fractures
Olecranon fractures are described as a break in the bony tip of the elbow that sticks out when you bend your arm. A fracture of the olecranon bone can be very painful and make motion of the elbow difficult or impossible. This kind of fracture is common and normally happens in isolation (with no other injuries involved).
Non-union Surgery (Elbow)
Non-union is the failure of a broken or fractured bone to heal properly even after appropriate treatment.
Ulnar Collateral Ligament (UCL) Repair with Internal Brace
UCL repair with an internal brace is a surgery that involves the use of collagen-coated tape (internal brace) surgically placed at the site of the damaged UCL ligaments. It provides better resistant and a faster recovery compared to traditional reconstruction surgery that involves the use of graft tissue from your body.
Conditions
Elbow Pain
Damage to any of the structures that make up the elbow joint can cause elbow pain. An elbow dislocation occurs when the bones that make up the joint are forced out of alignment as when you fall onto an outstretched hand.
Tennis Elbow
Tennis elbow is a common name for the elbow condition lateral epicondylitis. It is an overuse injury that causes inflammation and microtears of the tendons that attach to the lateral epicondyle.
Golfer's Elbow
Golfer’s elbow, also called medial epicondylitis, is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and microtears in the tendons that attach to the medial epicondyle.
Elbow Arthritis
Although the elbows are not weight-bearing joints, they are considered to be most important for the functioning of the upper limbs. Hence, even minor trauma or disease affecting the elbow may cause pain and limit the movements of the upper limbs. Arthritis is one of the common disease conditions affecting the elbow joint.
Elbow Impingement
Elbow impingement is a medical condition characterized by compression and injury of soft tissue structures, such as cartilage, at the back of the elbow or within the elbow joint. It is a condition caused by repetitive forced extensions and overuse of the elbow.
Elbow Trauma
The elbow is a complex joint of the upper limb, formed by the articulation of the long bone of the upper arm or humerus, and the two bones of the forearm - the radius and ulna. It is one of the important joints of the upper limb and is involved in basic movements such as bending and extending the arm and rotating the forearm.
Lateral Ulnar Collateral Ligament Injuries (Elbow)
A LUCL injury is a condition where the ligament is extremely stretched, or torn and detached from the elbow joint.
Elbow Dislocation
The bones are held together by ligaments to provide stability to the joint. Muscles and tendons move the bones around each other and help in performing various activities. Elbow dislocation occurs when the bones that make up the joint are forced out of alignment.
Elbow Sprain
An elbow sprain is an injury to the soft tissues of the elbow. It is caused due to stretching or tearing (partial or full) of the ligaments that support the elbow joint.
Elbow Injuries
Fracture is a common injury to the elbow. Elbow fractures may result from a fall onto an outstretched wrist, direct impact to the elbow or twisting injury. Elbow fractures may cause severe pain, swelling, tenderness, and painful movements.
Elbow Contracture
Elbow contracture refers to a stiff elbow with a limited range of motion. It is a common complication following elbow surgery, fractures, dislocations, and burns.
Bicep Tendon Tear at the Elbow
A biceps tear can be complete or partial. Partial biceps tendon tears will not completely break the tendon while complete tendon tears will break the tendon into two parts. Tears of the distal biceps tendon are usually complete and the muscle is separated from the bone. Tears of the distal biceps tendon most often result from a sudden injury or lifting a heavy object.
Distal Humerus Fractures of the Elbow
Injury in the distal humerus can cause impairment in the function of the elbow joint. A distal humerus fracture is a rare condition that occurs when there is a break in the lower end of the humerus.
Elbow Fractures in Children
Children’s bones have an area of developing cartilage tissue called a growth plate present at the end of long bones that will eventually develop into solid bone as the child grows.
Elbow Fractures
Elbow fractures may occur from trauma, resulting from various reasons: a fall on an outstretched arm, a direct blow to the elbow or an abnormal twist to the joint beyond its functional limit.
Cubital Tunnel Syndrome (Ulnar Nerve Entrapment)
When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump. When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed, leading to cubital tunnel syndrome.
Radial Head Fractures of the Elbow
Radial head fractures are very common and occur in almost 20% of acute elbow injuries. Elbow dislocations are generally associated with radial head fractures. Radial head fractures are more common in women than in men and occur more frequently in the age group of 30 to 40 years.
Elbow (Olecranon) Bursitis
Inflammation of the olecranon bursa leads to a condition called olecranon bursitis. The causes of elbow bursitis may include trauma or a hard blow on the elbow, excessive leaning on the elbow, infection by puncture wounds or insect bites, or conditions such as gout and rheumatoid arthritis.
Loose Bodies in the Elbow
Your elbow is a joint made up of three bones held together by muscles, ligaments, tendons, and cartilage. It is both a hinge and pivot joint allowing you to bend and rotate your elbow freely. Loose bodies in your elbow are small pieces of bone or cartilage that have broken off and are lying or floating free within the joint.
Throwing Injuries
An athlete uses an overhand throw to achieve greater speed and distance. Repeated throwing in sports such as baseball and basketball can place a lot of stress on the joints of the arm, and lead to weakening and ultimately, injury to the structures in the elbow.
Osteochondritis Dissecans of Elbow
Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of bone separates because of inadequate blood supply. The separated fragments are sometimes called “joint mice”. These fragments may be localized or may detach and fall into the joint space, causing pain and joint instability.
Osteochondritis Dissecans of the Capitellum
OCD of the capitellum is a localised fragmentation and separation of subchondral bone - meaning the bone below the cartilage - in your elbow.
Posterior Impingement of the Elbow
Posterior elbow impingement is a medical condition characterized by compression and injury of soft tissue structures such as cartilage at the posterior aspect (back) of the elbow joint. The impingement is caused by repetitive forced extensions and overuse of the elbow.
Lateral Impingement of the Elbow
Lateral elbow impingement is a medical condition characterized by compression and injury of the soft tissue structures, such as cartilage located at the outer aspect of the elbow joint. The impingement is caused by repetitive forced extensions and overuse of the elbow.
Triceps Injuries
The triceps or triceps brachii is a crucial muscle of the upper arm (humerus). It runs along the upper arm bone between the shoulder and elbow. The triceps tendons connect the triceps muscles to the shoulder blade and elbow in your arm.
Triceps Tendonitis
Triceps tendonitis is inflammation of the triceps tendon, the tissue that connects the triceps muscle on the back of the upper arm to the back of the elbow joint, allowing you to straighten your arm back after you have bent it.
Nursemaid's Elbow
Dislocation of the radius bone from the elbow is called nursemaid’s elbow. This condition is very common among children below 5 years of age as their bones and muscles are still in the developing stage.
Hyperextension Injury of the Elbow
Hyperextension injury of the elbow occurs when the elbow joint is bent beyond its normal range of motion, causing damage to the bones and ligaments of the elbow. It may also cause elbow dislocation. The condition is more common in tennis, football, weight-lifting and contact sports.
Radial Tunnel Syndrome
Radial tunnel syndrome is a painful condition caused by pressure on the radial nerve of the forearm. The entrapment or compression occurs frequently in the proximal forearm in the radial tunnel; a narrow space formed by muscles, bone, and tendon near the elbow joint.
Post-traumatic Stiffness (Elbow)
Post-traumatic stiffness is a disabling complication caused by trauma resulting in reduced or loss of motion and functional impairment.
Lateral Ulnar Collateral Ligament Injuries (Elbow)
A LUCL injury is a condition where the ligament is extremely stretched, or torn and detached from the elbow joint.
Elbow Anatomy
The elbow is a complex joint formed by the articulation of three bones – the humerus, radius, and ulna. The elbow joint helps in bending or straightening of the arm to 180 degrees and lifting or moving objects.
The bones of the elbow are supported by:
- Ligaments and tendons
- Muscles
- Nerves
- Blood vessels
Bones and Joints of the Elbow
The elbow joint is formed at the junction of three bones:
- The humerus (upper arm bone) forms the upper portion of the joint. The lower end of the humerus divides into two bony protrusions known as the medial and lateral epicondyles, which can be felt on either side of the elbow joint.
- The ulna is the larger bone of the forearm located on the inner surface of the joint. It articulates with the humerus.
- The radius is the smaller bone of the forearm situated on the outer surface of the joint. The head of the radius is circular and hollow, which allows movement with the humerus. The articulation between the ulna and radius helps the forearm to rotate.
The elbow consists of three joints, namely:
- The humeroulnar joint is formed between the humerus and ulna and allows flexion and extension of the arm.
- The humeroradial joint is formed between the radius and humerus and allows movements like flexion, extension, supination, and pronation.
- The radioulnar joint is formed between the ulna and radius bones and allows rotation of the lower arm.
Articular cartilage lines the articulating regions of the humerus, radius, and ulna. It is a thin, tough, flexible and slippery surface that acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated with synovial fluid, which further enables the smooth movement of the bones.
Muscles of the Elbow Joint
There are several muscles extending across the elbow joint that help in various movements. These include the following:
- Biceps brachii: Upper arm muscle, enabling flexion of the arm
- Triceps brachii: Muscle in the back of the upper arm that extends the arm and fixes the elbow during fine movements
- Brachialis: Upper arm muscle beneath the biceps, which flexes the elbow towards the body
- Brachioradialis: Forearm muscle that flexes, straightens and pulls the arm at the elbow
- Pronator teres: Muscle that extends from the humeral head, across the elbow, and towards the ulna, and helps to turn the palm facing backwards
- Extensor carpi radialis brevis: Forearm muscle that helps in movement of the hand
- Extensor digitorum: Forearm muscle that helps in movement of the fingers
Ligaments and Tendons of the Elbow
The elbow joint is supported by ligaments and tendons, which provide stability to the joint.
Ligaments are a group of firm tissues that connect bones to other bones. The most important ligaments of the elbow joint are the:
- Medial or ulnar collateral ligament: Comprised of triangular bands of tissue on the inner side of the elbow joint
- Lateral or radial collateral ligament: A thin band of tissue on the outer side of the elbow joint
- Annular ligament: Group of fibres that surround the radial head, and hold the ulna and radius tightly in place during movement of the arm
Together, the medial and lateral ligaments are the main source of stability and hold the humerus and ulna tightly in place during movement of the arm.
The ligaments around a joint combine to form a joint capsule that contains synovial fluid.
Any injury to these ligaments can lead to instability of the elbow joint.
Tendons are bands of connective tissue fibres that connect muscle to bone. The various tendons that surround the elbow joint include:
- Biceps tendon: attaches the biceps muscle to the radius, allowing the elbow to bend
- Triceps tendon: attaches the triceps muscle to the ulna, allowing the elbow to straighten
Nerves of the Elbow
The main nerves of the elbow joint are the ulnar, radial and median nerves. These nerves transfer signals from the brain to the muscles that aid in elbow movements. They also carry sensory signals such as touch, pain, and temperature back to the brain.
Any injury or damage to these nerves causes pain, weakness or joint instability.
Blood Vessels Supplying the Elbow
Arteries are blood vessels that carry oxygen-pure blood from the heart to the hand. The main artery of the elbow is the brachial artery that travels across the inside of the elbow and divides into two small branches below the elbow to form the ulnar and the radial artery.