This handout explains the follow-up care after surgery to repair your elbow fracture. The surgery was important in order to repair the joint surface and to avoid arthritis. Depending on the type of fracture, you may have a drain in place to remove excess fluid. While the drain is in place, please make sure to take the oral antibiotics that were prescribed. We will coordinate an appointment with you within 48 hours to remove the drain. Alternatively, the nurses can instruct you on how to remove it at home, if you prefer.

The splint is there for your protection, to stabilize your elbow. It is important to move your fingers throughout the day to avoid stiffness, but please do not lift anything heavy with your arm. We will coordinate a therapy appointment with you within 3-7 days to begin gentle range of motion exercises to alleviate elbow stiffness. Due to the anesthesia block and local anesthetic, you may notice numbness in your hand for up to 24 hours. If the incision is red or if there is drainage coming out of it, please call us right away. The phone number is listed on the bottom of this page. Go to the emergency room if this occurs at a night or on a weekend.

Wound Care:

  • Metal plate or screws are often used to repair elbow fractures, to keep the bones in place while they heal.

  • After surgery, most patients have their arm wrapped in a bulky dressing (bandage) and a plaster splint that goes above the elbow. The splint cannot be removed and you must keep it clean and dry. Cover the splint with the plastic bag whenever you shower.

Pain Management:

  • Please check with the postoperative nurses or the medical staff at Bellevue Bone & Joint Physicians about how to manage your pain medication. To best manage your pain, you must take the pain medication the way it was prescribed. Taking the correct dose at the right time is very important, especially to avoid pain, nausea and constipation.
  • You will receive a prescription for narcotic pain medication. Take this with your medication, as directed. It is important to take your medication on time to “stay ahead” of your pain and avoid having to play “catch up” for significant increases in pain.
  • Medication for nausea will also be provided. Please make sure to take this as directed.
  • If you have uncomfortable side effects from the pain medication, please call us at 425-462-9800.
  • It is normal to have some pain off and on for approximately one year after surgery, particularly in cold weather.

Driving:

  • Do not drive if you are taking narcotic medications, as it is not safe and against Washington state law. Taking narcotic medication can make you sleepy and delay your reaction time.
  • Once you are no longer taking narcotic medication, you may drive as soon as you can comfortably grip the steering wheel with both hands.

Activity:

  • Move your fingers throughout the day to help prevent stiffness. Try bending and straightening your fingers five to six times a day.
  • Because you will not be using your arm for everyday activities, it is important to exercise your shoulder to prevent stiffness. Exercise your shoulder by lifting it overhead several times a day.
  • Elevate your arm to help lessen the swelling, pain and joint stiffness. You may also use an ice pack for 20 minutes at a time over the surgical dressing, to help reduce swelling in your hand and relief pain. Place a thin cloth between the ice pack and dressing to protect your skin.
  • Do not lift any objects heavier than a pencil until your sutures have been removed.
  • You may be able to do some typing or writing right after surgery. However, swelling or stiffness may make it hard to do these things for the first three to six weeks after surgery.
  • Please let us know if you need a letter or documentation regarding your disability or injury. If you are a student, this information can be very helpful for you to gain assistance with writing, typing, and exam taking.

Follow-Up:

  • Elbow fractures have a significant problem with joint stiffness and therefore a therapy is generally started two to four days after surgery. Please contact our office at the number below, if an appointment has nit been made. The upper extremity therapist will remove the bulky dressing so that exercises can begin, and a protective splint will be made.
  • Sutures are generally removed 10-14 days after surgery and typically in two stages to prevent the incision edges from separating during therapy.
  • The removable brace or splint is used for protection for approximately six weeks after the surgery.
  • Therapy after elbow fracture surgery can last as long as three months. At first, you will need therapy two to three times a week. As your fracture heals and you become more familiar with your home exercises program, you will have therapy one time a week and then every two weeks until you regain good motion and strength.
  • Do not do any weightlifting or strengthening exercises without talking to your surgeon or physical therapist.

Results:

  • Most patients take about three months to get most of their strength and range of motion back, and many need therapy during that time.
  • Many patients recover well after the treatment of their elbow fractures. Most are able to return to their work and recreational activity after the fracture is healed. Patients often notice a vigorous therapy program improves healing.
  • Patients often choose to remove a portion of the hardware because the skin around the elbow is thin and there is no soft tissue padding over metal screws or pins. The surgery is typically elective and can be scheduled at your convenience.

Thomas E. Trumble, M.D.

*Figures courtesy of Principles of Hand Surgery and Therapy by Thomas E. Trumble, MD, Ghazi M. Rayan, MD, Mark E. Baratz, MD and Jeffrey E. Budoff, MD