Post-Surgery Concerns for Olecranon Fracture: Recovery and Rehabilitation

Postoperative Issues After Olecranon Fracture Surgery

Hello Doctor: I was involved in a car accident in February that resulted in a comminuted fracture of the coronoid process, which was treated with a steel plate.
It has been a little over a month since the surgery.
My attending physician advised me to wait until the bone has healed before starting rehabilitation, and to perform range of motion exercises at home.
However, I found online that most people begin rehabilitation after about one month.
My next follow-up appointment is in two weeks, which will be approximately two months post-surgery.
I'm concerned if starting rehabilitation at two months will be too late.

Additionally, I have another issue: when I stay in a fixed position for too long and try to return to a neutral position, I experience a bone pain sensation between my shoulder and arm (possibly nerve pain).
I mentioned this to my attending physician, who said that X-rays taken before the surgery showed that the bones in my shoulder and upper arm are normal.
He indicated that the pain might be due to nerve-related issues, which is considered normal.
Is this indeed normal, and if so, how long might it take to improve? I haven't found any other cases similar to mine.

Mr. You, 20~29 year old female. Ask Date: 2017/04/04

Dr. Chen Yongxue reply Orthopedics

The rehabilitation schedule should ideally begin once the fracture has initially healed for safety reasons.
In patients with locked plates, rehabilitation can be initiated a bit earlier, which is related to the degree of fracture comminution.
However, it is essential to follow the recommendations of the attending surgeon.
It is common to experience soreness and joint stiffness during rehabilitation.
Applying heat can help alleviate discomfort.
The duration of these sensations varies from person to person; generally, patients who are more diligent in their rehabilitation tend to experience a quicker resolution of discomfort.
If there are any other concerns, it is advisable to visit the outpatient clinic for an examination.
Thank you.

Reply Date: 2017/04/04

More Info

After experiencing a comminuted olecranon fracture due to a car accident, your concerns regarding recovery and rehabilitation are completely valid. The olecranon, which is the bony prominence of the elbow, plays a crucial role in the function of the arm, particularly in movements involving the elbow joint.
In your case, the surgical intervention involved the insertion of a steel plate to stabilize the fracture. This is a common approach for such fractures, especially when they are comminuted, as it allows for proper alignment and healing of the bone. The timeline for recovery can vary significantly based on the severity of the fracture, the surgical technique used, and individual healing responses.

Typically, after surgery for an olecranon fracture, the initial focus is on protecting the surgical site and allowing the bone to heal. This often means immobilization for a period of time, which can range from a few weeks to several months, depending on the specifics of your injury and the surgeon's protocol. Your physician's recommendation to wait until the bone has healed before starting rehabilitation is standard practice. This is to ensure that the fracture site is stable enough to withstand the stresses of rehabilitation exercises without risking re-injury.

Regarding your concern about starting rehabilitation two months post-surgery, it is generally not too late to begin rehabilitation at that point. In fact, many rehabilitation protocols for fractures start around six to eight weeks post-surgery, depending on the type of fracture and the healing progress. However, it is crucial to follow your physician's advice and to have a tailored rehabilitation program designed by a physical therapist who understands your specific situation. They can help you gradually increase your range of motion and strength while ensuring that you do not compromise the healing process.

As for the pain you are experiencing between your shoulder and arm, it is not uncommon for patients recovering from elbow surgery to experience referred pain or discomfort in adjacent areas. This can be due to a variety of factors, including muscle tension, nerve irritation, or even compensatory movements that occur when you are trying to protect the injured area. If your physician has confirmed that there are no structural issues in your shoulder or upper arm based on X-rays, it is likely that this discomfort is related to the healing process and the adjustments your body is making post-surgery.

The duration of this discomfort can vary widely among individuals. It may improve as you begin rehabilitation and regain strength and mobility in your elbow. Engaging in gentle stretching and strengthening exercises, as advised by your physical therapist, can help alleviate some of this discomfort over time. Additionally, modalities such as heat, ice, or electrical stimulation may be beneficial in managing pain and promoting healing.

In summary, while it is essential to adhere to your physician's recommendations regarding the timing of rehabilitation, starting physical therapy two months post-surgery is generally acceptable and can be beneficial. The pain you are experiencing may be a normal part of the recovery process, but it is always advisable to keep an open line of communication with your healthcare provider regarding any new or worsening symptoms. They can provide you with the best guidance tailored to your specific recovery journey.

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