Elbow Fractures: Surgery and Hyaluronic Acid Injections

Elbow Fracture (Part II)

Hello, Doctor! Thank you for your previous response! I am currently continuing with outpatient treatment, but the rehabilitation results are still not satisfactory.
My left arm can bend normally but cannot reach my shoulder; it can extend to about 160 degrees.
After rehabilitation, I can touch my shoulder and extend it to 180 degrees (but it cannot be as straight as my right arm)! However, within half an hour, it returns to normal, and this has been ongoing for almost two months without improvement! After considering the situation, my attending physician has decided to proceed with surgery, as the swelling in my elbow joint has persisted for over two months (an ultrasound indicated it might be caused by bone fragments)! The surgery will involve joint mobilization and cleaning out the bone fragments.
The doctor also mentioned that I could opt for a self-paid injection of hyaluronic acid, which could help with bending and straightening.
I would like to ask if hyaluronic acid can really help with bending? I am currently discussing with my family whether to proceed with the surgery, as this would be my third operation!

Mr. Hsu, 30~39 year old female. Ask Date: 2013/09/24

Dr. Shi Guozheng reply Orthopedics

Continuous rehabilitation is necessary; hyaluronic acid may not necessarily improve joint mobility.
It primarily serves to lubricate the surface cartilage and has some effect in delaying the progression of osteoarthritis.

Reply Date: 2013/09/24

More Info

When it comes to elbow fractures and the potential treatments available, including surgery and hyaluronic acid injections, it's essential to understand the underlying issues and the expected outcomes of each approach.

Firstly, elbow fractures can lead to significant complications, including stiffness, pain, and limited range of motion. In your case, it seems that despite ongoing rehabilitation, you're experiencing persistent limitations in your elbow's flexibility, with a range of motion that does not fully return to normal even after therapy sessions. This is not uncommon, especially in cases where there has been significant trauma or bone fragments that may be impinging on joint movement.

The decision to proceed with surgery, particularly after two months of conservative management, is often made when the physician believes that the benefits of surgical intervention outweigh the risks. In your situation, the presence of swelling and the ultrasound findings indicating bone fragments suggest that there may be mechanical issues within the joint that are preventing normal movement. Surgical intervention, such as joint mobilization and removal of loose bone fragments, can help restore function and alleviate pain.

Regarding hyaluronic acid injections, these are often used in the treatment of osteoarthritis and joint pain. Hyaluronic acid is a naturally occurring substance in the body that helps lubricate joints and can provide cushioning. In the context of elbow fractures, while hyaluronic acid injections may help improve joint lubrication and potentially reduce pain, they are not a guaranteed solution for restoring full range of motion. The injections may provide symptomatic relief, but they do not address the mechanical issues caused by bone fragments or joint stiffness resulting from the fracture.

It's important to note that while hyaluronic acid can help with joint lubrication, its effectiveness in improving range of motion specifically after a fracture is limited. The primary goal of such injections is to alleviate pain and improve the quality of life rather than directly enhancing the flexibility of the joint. Therefore, if the underlying mechanical issues are not resolved through surgery, the injections may not lead to the desired improvement in bending and straightening the elbow.

In conclusion, if your physician has recommended surgery due to persistent swelling and limited range of motion, it may be a prudent choice, especially if conservative measures have not yielded significant improvements. Hyaluronic acid injections could be considered as an adjunct treatment post-surgery to help with pain management and joint lubrication, but they should not be viewed as a primary solution for restoring range of motion. Discussing these options thoroughly with your healthcare provider and considering the potential benefits and risks of each approach will be crucial in making an informed decision about your treatment plan.

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