Elbow

There are two main types of distal biceps tendon injuries: 

• Partial tears: In partial tears, the tendon is damaged but not completely ruptured. This type of injury may cause pain, weakness, and limited range of motion in the affected arm.
• Complete tears: In complete tears, the tendon is completely severed from its attachment point on the radius bone. This type of injury typically causes severe pain, weakness, and a noticeable bulge or deformity in the upper arm, known as a “Popeye deformity” due to the retracted biceps muscle.

• Conservative treatment: This may include rest, activity modification, pain management, and physical therapy to strengthen surrounding muscles and improve range of motion. Conservative treatment is typically recommended for partial tears or for individuals who may not be good candidates for surgery.
• Surgical repair: Surgical intervention is often recommended for complete tears or partial tears with significant functional impairment. The goal of surgery is to reattach the torn tendon to the radius bone and restore elbow function. Different surgical techniques may be used depending on the specific characteristics of the injury and the patient’s individual circumstances.

Distal Biceps Tendon Repairs

Distal biceps tendon repair surgery is a procedure performed to reattach a completely torn distal biceps tendon back to its original attachment point on the radius bone near the elbow joint. This surgical intervention is typically recommended for individuals who have sustained a complete tear of the distal biceps tendon and who desire restoration of elbow function and strength.

Here’s an overview of the surgical procedure:

• Preparation: The patient is placed under general anesthesia or regional anesthesia, depending on the surgeon’s preference and the patient’s medical condition. The affected arm is cleansed and sterilized, and a tourniquet may be applied to temporarily restrict blood flow to the area.
• Incision: The surgeon makes an incision over the front of the elbow to expose the torn distal biceps tendon and the attachment site on the radius bone. The size and location of the incision may vary depending on the specific technique used and the surgeon’s preference.
• Tendon preparation: The torn end of the distal biceps tendon is identified and prepared for reattachment. Any scar tissue or unhealthy tissue is removed to facilitate proper healing. The tendon may be trimmed to ensure a clean edge for reattachment.
• Bone preparation: The attachment site on the radius bone is carefully prepared to create a stable base for the reattached tendon. This may involve removing any remaining tendon tissue, roughening the bone surface, and creating holes or channels to secure the tendon in place.
• Tendon reattachment: The surgeon passes sutures through the tendon and anchors them securely to the prepared bone surface using various techniques. Common methods include using suture anchors, bone tunnels, or buttons to secure the tendon in its anatomical position.
• Closure: Once the tendon has been successfully reattached, the incision is closed with sutures or surgical staples. Sterile dressings are applied to the surgical site, and a splint or brace may be placed to protect the elbow during the initial stages of healing.
• Rehabilitation: Following surgery, the patient undergoes a structured rehabilitation program supervised by a physical therapist. The rehabilitation process typically involves a gradual progression of exercises to restore strength, flexibility, and range of motion in the affected arm.

Overall, distal biceps tendon repair surgery is a highly successful procedure that can effectively restore elbow function and strength in individuals with complete tears of the distal biceps tendon. It is essential for patients to follow their surgeon’s postoperative instructions and adhere to their rehabilitation program to achieve the best possible outcomes.

Here’s an overview of the distal biceps tendon reconstruction procedure:

• Preparation: The patient is placed under general anesthesia or regional anesthesia. The affected arm is cleansed and sterilized, and a tourniquet may be applied to temporarily restrict blood flow to the area.
• Incision: The surgeon makes an incision over the front of the elbow to expose the torn or damaged distal biceps tendon and the attachment site on the radius bone. The size and location of the incision may vary depending on the specific technique used and the surgeon’s preference.
• Tendon graft harvesting: If the distal biceps tendon is irreparable, a tendon graft may be harvested from another part of the body, typically the hamstring tendon or a donor tendon. The harvested tendon graft is prepared and sized to match the dimensions of the original distal biceps tendon.
• Bone preparation: The attachment site on the radius bone is carefully prepared to create a stable base for the reconstructed tendon. This may involve removing any remaining tendon tissue, roughening the bone surface, and creating holes or channels to secure the tendon graft in place.
• Tendon graft insertion: The surgeon passes sutures through the tendon graft and anchors them securely to the prepared bone surface using various techniques. Common methods include using suture anchors, bone tunnels, or buttons to secure the tendon graft in its anatomical position.
• Closure: Once the tendon graft has been successfully inserted and secured, the incision is closed with sutures or surgical staples. Sterile dressings are applied to the surgical site, and a splint or brace may be placed to protect the elbow during the initial stages of healing.
• Rehabilitation: Following surgery, the patient undergoes a structured rehabilitation program supervised by a physical therapist. The rehabilitation process typically involves a gradual progression of exercises to restore strength, flexibility, and range of motion in the affected arm.

Distal biceps tendon reconstruction is a complex procedure that requires careful surgical technique and postoperative rehabilitation. It is essential for patients to follow their surgeon’s postoperative instructions and adhere to their rehabilitation program to achieve the best possible outcomes.

OCD (Osteochondritis Dissecans) of the Capitellum

Osteochondritis Dissecans (OCD) of the capitellum is a condition characterized by the detachment of a fragment of bone and cartilage from the surface of the capitellum, which is the rounded part of the humerus bone at the elbow joint. OCD of the capitellum typically affects adolescents involved in overhead sports such as baseball, gymnastics, or tennis, though it can occur in individuals of any age. 

Here’s an overview of osteochondritis Diissecans of the capitellum:

• Cause: The exact cause of OCD of the capitellum is not fully understood, but it is believed to result from repetitive stress or trauma to the elbow joint, particularly in young athletes whose bones are still developing. Overuse, improper throwing mechanics, and high-impact activities can contribute to the development of this condition.
• Symptoms: Common symptoms of OCD of the capitellum include pain, swelling, and tenderness on the lateral aspect of the elbow joint. The affected individual may experience difficulty fully extending or flexing the elbow and may notice a decrease in throwing velocity or accuracy. In some cases, there may be a sensation of locking or catching within the joint.
• Diagnosis: Diagnosis of OCD of the capitellum typically involves a physical examination, including an assessment of range of motion and joint stability, as well as imaging studies such as X-rays, MRI (magnetic resonance imaging), or CT (computed tomography) scans. These imaging tests can help visualize the extent of the lesion and determine the appropriate treatment approach.
• Treatment: Treatment options for OCD of the capitellum depend on various factors, including the size and stability of the lesion, the individual’s age, activity level, and symptoms. Conservative treatments may include rest, activity modification, physical therapy, and nonsteroidal anti-inflammatory medications to reduce pain and inflammation. In cases where conservative measures fail to relieve symptoms or if the lesion is large or unstable, surgical intervention may be necessary. Surgical options may include debridement (removal of loose fragments), microfracture, drilling, or fixation of the lesion using screws or pins to promote healing.
• Rehabilitation: Rehabilitation following treatment for OCD of the capitellum is crucial for optimizing outcomes and preventing recurrence. Physical therapy exercises are typically prescribed to improve range of motion, strength, and joint stability, as well as to facilitate a gradual return to sports or other activities.

Overall, early recognition and appropriate management of OCD of the capitellum are essential for minimizing long-term complications and maximizing the individual’s functional recovery. Prompt evaluation by a healthcare professional with experience in treating elbow injuries is recommended for individuals experiencing symptoms suggestive of this condition.

Cartilage Repair/Restoration 

Cartilage repair or restoration in the elbow involves techniques to stimulate the growth of new cartilage, addressing damage from injury or arthritis. This procedure aims to relieve pain, improve joint function, and can delay or prevent the progression toward arthritis.

Elbow Arthroscopy 

Elbow arthroscopy is a minimally invasive surgery using a camera and instruments through small incisions to diagnose and treat a variety of elbow problems. This technique can address issues like loose bodies, cartilage damage, and arthritis, offering a quicker recovery than open surgery.

UCL Reconstruction 

UCL reconstruction, often known as Tommy John surgery, involves replacing the ulnar collateral ligament in the elbow with a tendon from elsewhere in the body. It’s primarily performed on athletes, especially baseball pitchers, to restore stability and function to the elbow.

Lateral and Medial Epicondylitis (Tennis and Golfer’s Elbow) 

This treatment addresses pain on the outside (lateral) and inside (medial) of the elbow, commonly known as tennis and golfer’s elbow, respectively. Treatment ranges from physical therapy to surgery, aiming to relieve pain and restore the strength of affected tendons.

Cubital Tunnel Syndrome 

This condition is caused by pressure on the ulnar nerve at the elbow. Treatment may include non-surgical options or surgery to relieve pressure on the nerve, addressing symptoms such as pain, numbness, and tingling in the arm and fingers.

Triceps Repair 

Triceps repair involves surgical reattachment of the triceps tendon to the bone at the back of the elbow. This procedure is typically required after injuries leading to partial or complete tears of the tendon, aiming to restore arm strength and function.

Elbow Dislocations/Ligament Repair 

Treatment for elbow dislocations and associated ligament injuries may involve repositioning the dislocated bone and repairing damaged ligaments. This can restore elbow stability, function, and range of motion, with options ranging from conservative management to surgical intervention for severe cases.