2nd Radial head replacement

[silverfish]

Hi, First post

Bit of background. I'm a fit and active 36 year old male, ex military, partake in a lot of physical past times.

I fracture dislocated my left elbow MAY 07.
The surgeon was unable to rebuild the radial head so put a metal prosthesis in as well as having to reattach all my ligaments.

I had an uneventful recovery with good range of movement (relatively) I then developed an infection which led to having the radial head washed out, eventually leading to removal of radial head

This led to a 4mm impaction of the ulna in the wrist leading to severe pain and reduced range of movement

Since I have had another radial head prosthesis put in along with the potential of having to have my ulna shortened if the wrist impaction doesn't resolve.

6 months down the line PRESENT DAY

My surgeon has explained that I have a good compromise, good range of movement and reduced wrist pain. This is as good as it gets, infact I will have to be reviewed six monthly as he described it as a degenerative condition (bone against metal wears out) expect arthritic condition within 7 years

When I asked about physio to build some strength and protection back in to the elbow, he said there was nothing that would help. He was adamant that nothing will improve my short/medium/long term discomfort and prognosis

In fact I asked the physio on the ward and she scratched her head and suggested I googled the problem..................

I'm sure some physio would be more than helpful. at present I am doing grip exercises and gross upper body exercise with medium therabands

The elbow has marked crepitus and "clonking" which appears to have improved with use (I am six months post surgery)

Can you advise, is it really that black and white?

Apologies for the longwinded first post

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[pudding_bowl]

Alot of orthopaedic surgeons don't believe in physiotherapy - I'v met a few along the way, and as a result their patient get much poorer results.
That said - it's a very specific surgery you'v had done and I don't have experience with it, so your surgeon could be entirely correct.
You said you've been exercising it and that they clonking appears to have improved? If your getting better then keep doing what your doing. Don't increase weights rapidly as your biceps attach very close to the radial head, and increased tension could thus mess with the replacment.

How are you doing now - 2 months on from your post (sorry)
Pudding

[silverfish]

Cheers for the reply

8 months from last surgery and have been reviewed idependently and told I need my ulna shortening as still impacting on wrist badly

Prognosis appears to be degeneration of articular surfaces, and loosening of radial head implant and generally pain and discomfort for the rest of my life

I'm amazed there is no apparent physio that could help in any way to at least reduce the degeneration of the elbow and wrist

The problem is I've yet to come across a physio who has dealt with this. My google fu is week on this one

[steve 1971]

hello mate. i know this thread is a couple years old but like you were at the time i am clutching at straws. i've had the same surgery and like you in lot of pain and just been told nothing more can be done and i have to live with it at 41 and get on with things......Until i will eventually need a total elbow replacement. just wondered what stage you are in at present with pain and mobility as looks like we pcjed an awkward surgery to have to us....
Regards steve

[Webbydoc]

I too am dealing with the same issue. I broke my left radial head on 3 June 2012 and had to have a radial head replacement on the 8th since it was way too crushed to save. I even took a chunk of the ball off the humerus. I am prior military and have always been quite active, was doing P90X and Insanity just before accident. So when I was cleared for full activity I went right back to push-ups and attempting pull-ups. This was an epic fail! I think it was too much too fast. That was in September of 2012 and I stopped all arm activity one month later because of severe pain. Here it is mid January and I am no better. I start occupational therapy again tomorrow for e-stem and ice to hopefully help with the pain. Also in February I will start going to a pain management clinic. Not quite sure what they do there and how they will help, I am looking for anything that is non pill related, can't stand that stuff. I can't even sleep at night because my elbow gets so stiff and sore!
~ Webbydoc

[KakiWo]

I too am dealing with the same issue. I broke my left radial head on 3 June 2012 and had to have a radial head replacement on the 8th since it was way too crushed to save. I even took a chunk of the ball off the humerus. I am prior military and have always been quite active, was doing P90X and Insanity just before accident. So when I was cleared for full activity I went right back to push-ups and attempting pull-ups. This was an epic fail! I think it was too much too fast. That was in September of 2012 and I stopped all arm activity one month later because of severe pain. Here it is mid January and I am no better. I start occupational therapy again tomorrow for e-stem and ice to hopefully help with the pain. Also in February I will start going to a pain management clinic. Not quite sure what they do there and how they will help, I am looking for anything that is non pill related, can't stand that stuff. I can't even sleep at night because my elbow gets so stiff and sore!
~ Webbydoc

My injury is old, but the treatment is the same. I broke my L elbow almost 40 yrs ago. I lost most ROM in the elbow at the time of injury, so I became accustomed to it. I had the radial head removed 6 years ago due to severe arthritis and pain. I did help for a while. Now the forearm is unstable and the pain is back. I sure there is more arthritis in there top. My doctor is recommending a radial head implant to start. If that doesn't work, then a one-bone forearm. I'm trying to hold out as long as I can, because there seems to be no great answers.

Ice is my best friend. I have 2 that I can wrap around my elbow and still do other things. I can't take NSAIDs, and I don't like the narcotics either. I hope you have found some help for the pain.

[pudding_bowl]

Yes you've definately done well to get such a rare injury :P
Perhaps talking to your specialist (the new independant one) and asking them if they know of a physio who has seen it before.
Thanks for your post - it definately made me think.
I'v not seen it before. If I can find any information then I will send it your way.