Elbow Fractures: Healing, Surgery, and Rehabilitation - Orthopedics

More Info

---

Hello! Thank you for your detailed inquiry regarding your elbow fracture and the associated healing process. It sounds like you have been through quite a challenging time with your injury, and I’m here to provide some insights based on your situation.

From your description, it seems that you have been dealing with an olecranon fracture (the bony prominence of the elbow) that has not yet healed, despite being in a cast for seven weeks. The decision to remove the hardware (screws or pins) is typically based on several factors, including the healing status of the fracture, the presence of any complications, and the overall function of the joint.

1. Can the screws be removed if the olecranon fracture has not healed?
Generally, if the fracture has not healed, it is not advisable to remove the screws. The screws provide stability to the fracture site, and removing them prematurely could lead to further complications, such as non-union (where the bone fails to heal) or malunion (where the bone heals incorrectly). Your doctor’s suggestion to wait until the fracture heals naturally after the removal of the screws is not standard practice. It is essential to ensure that the fracture has adequate stability before considering hardware removal.

2. Joint Stiffness and Rehabilitation
You mentioned experiencing stiffness in your elbow joint, with a range of motion from 35 to 145 degrees. This stiffness is not uncommon after an elbow fracture, especially if the joint has been immobilized for an extended period. Joint mobilization techniques, such as passive range of motion exercises, can be beneficial. If you have already undergone joint mobilization therapy twice and are still experiencing stiffness, it may be appropriate to continue this therapy under the guidance of a physical therapist. They can assess your progress and determine the best course of action.

3. Additional Treatment Options
Besides physical therapy, there are other methods to address joint stiffness. These may include:
- Therapeutic modalities: Heat, ice, ultrasound, or electrical stimulation can help reduce pain and improve mobility.

- Manual therapy: A skilled therapist can perform hands-on techniques to improve joint mobility.

- Home exercises: Consistent, gentle stretching and strengthening exercises can aid recovery.

- Hydrotherapy: Exercising in water can reduce stress on the joint while allowing for movement.

4. Timeline for Healing and Rehabilitation
The healing time for an olecranon fracture can vary significantly based on the severity of the fracture and the individual’s overall health. Typically, it may take anywhere from 6 to 12 weeks for the fracture to heal sufficiently. After hardware removal, rehabilitation can begin, focusing on regaining range of motion and strength. Full recovery can take several months, and while many individuals regain full function, some may experience lingering stiffness or discomfort.

5. What if the olecranon fracture does not heal after screw removal?
If the fracture remains unhealed after the screws are removed, further evaluation may be necessary. This could involve imaging studies to assess the fracture site and determine the best course of action, which may include additional surgical intervention or more intensive rehabilitation.

In conclusion, it is crucial to have open communication with your orthopedic surgeon regarding your concerns about hardware removal and the status of your fracture healing. They can provide personalized recommendations based on your specific case. Continuing with physical therapy and exploring additional treatment options can significantly aid in your recovery. Remember, patience and adherence to your rehabilitation program are key to achieving the best possible outcome. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare provider. Best wishes for your recovery!