Elbow Replacement Case Study

A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon

The surgery being performed on your son consists of a few different procedures. First, what we did was to identify the muscles, blood vessels and nerves in both the arm and the stump. Then Dr. Ramos will trim the wound, and insert the supporting plate. This is what is holding your son’s arm in place, and also made reattachment possible. Before we did this, he had to trim the bone, which will make the right arm one inch shorter then the left arm. With the supporting plate in place, we will then be able to reattach everything else. The only bad news is that unfortunately Jim will never regain entire use of his right arm. Although all the vessels and muscles are connected properly the nervous system is too damaged to send messages to the brain. Because of this, recovering movement capabilities will be a slow process. Although with practice and physical therapy, Jim will slowly regain function and strength.

So far, I have told you the good news, the bad news is that his arm will probably never gain the same movement it once had. The nerves in his arm can never be attached the same as they were before once they have been severed the way your sons have been. This unfortunately means he might have a little bit of trouble from this arm throughout his lifetime. The movement in his arm, forearm, and hand will be very limited an awkward for him. Jim will probably have trouble playing

swelling, regain range of motion, and strength. Even if surgery is needed, achieving as much knee motion and strength as possible can greatly reduce complications after surgery. Immediately after an ACL injury, the so-called R.I.C.E. treatment is recommended. R.I.C.E. stands for rest, ice, compression, and elevation.

A September 7 elbow fracture during the Double-A playoffs will cause minor league second baseman Ozzie Albies to miss the remainder of the playoff season with his team, the Mississippi Braves. The 19-year-old, who was expected to be one of the stars of the playoffs, had split his time this year between the Mississippi Braves and the franchise's Triple-A team, the Gwinnett Braves. Although Albies' injury will require surgery, he should be able to return to playing baseball by January.

How would you feel if you broke your arm and you didn't have access to a doctor? It wouldn't be fun would it? Now pretend that broken arm is depression and the doctor is actually a psychologist. Having access to a doctor who treats mental illness is just as important as having access to a doctor who would treat a broken arm. Access to mental health care needs to increase to reduce the effects of untreated mental illness.

Russell Carrington is a 25 year old right handed relief pitcher for the MLB team the Baltimore Orioles. Carrington has been playing baseball since he was seven years old and this was his third season in the Major Leagues. Carrington was at the mound and in the motion of throwing a fastball, when he felt a “pop” in his overhand motion. He dropped to his knees and clinched his right shoulder in pain. Athletic trainers came onto the field an upon examination Carrington stated his arm felt like it was “dead” and felt like it was “catching”. Carrington was seen by the team physician. She performed ROM exercises, strength, and stability tests on his shoulder and examined his neck and head to ensure pain wasn’t coming from a pinched nerve. She concluded that further testing and imaging was necessary. Carrington had an X-ray and MRI done on his shoulder and he was diagnosed with a type II SLAP (Superior Labrum Anterior and Posterior) lesion. He didn’t want surgery done because he would miss the remainder of the season and possibly the next, so doctors prescribed non-steroid anti-inflammatory medication and five months physical therapy to strengthen the shoulder capsule. After completion of physical therapy, the pain didn’t improve and arthroscopy surgery was recommended.

While common in baseball players due to its success, the Tommy John surgery is also effective for restoring torn rotator cuffs in individuals who do not play sports.

“More pitchers are going through the procedure a second time, and aside from the mental and physical toll it takes on players.” They still try to pitch through the pain an end up getting hurt again. “It's a one-percent rate in the literature, one out of 100 Tommy Johns requires a second surgery.” Most surgeons do a good job on their arms. Pitchers have the worst trouble after the first surgery when their arms hurt bad enough so they have to have a second surgery.

Former NFL team doctor, David Chao also agreed with Bowen's statement saying that the injury will require surgery and he'll need 6-9 months to recover.

The surgery was frist performed in 1974 by orthopedic surgen Dr. Frank Jobe, was named after the first baseball player to undergo this surgery; Tommy John was the major league pitcher whose record of 288 career victories ranks seventh all time. This procedure is made to help a person with UCL also known as ulnar collateral ligament also known as the elbow. The procedure is common among collegiate and professional athletes in several sport, but most in baesball. The procedure goes as follow, the patient’s arm is open up aroung the elbow. Holes to accommodate a new tendon are drilled in the ulna and humerus ones of the elbow. The doctor then gets a tendon such as the palmaris tendon from the forearm of the same or opposite elbow, the patellar tendon, or a cadeveric tendon. Which are ten woven in a figure eight pattern through the holes and anchored. The ulnar nevre is usually moved to prevent pain as scar tissue can appy pressure to the nerve.

Current/ongoing research on Tommy John surgery is focusing on the success of different surgical methods, rehabilitation techniques, and prevention/protection of Ulnar Collateral Ligament Injury. Tommy John surgery is

Many major league and teenage pitchers today are requiring Tommy John surgery more than before. Tommy John surgery is named after the pitcher Tommy John, who was the first to receive this surgery. This particular arm injury is located in the elbow when the Ulnar Collateral Ligament tears. During the surgery, the UCL is reconstructed with another ligament from one’s body or a donor. Many people argue that this injury is a result of overuse/overthrowing, not giving the arm enough rest. Also, people argue that it is a result of improper throwing techniques. Both of those arguments are accurate, as they can both result in Tommy John surgery. Today in baseball, more and more people are getting arm injuries and needing Tommy

7/6/16 I met Mr. Abraham at the office of Dr. Yacisen. Mr. Abraham arrived using a can and wearing the leg brace. There is swelling to the ankle and some tenderness to the surrounding knee. He rates his pain at a 1 and a 5 with some movements. The range of motion is limited. We also asked Dr. Yacisen to address the left shoulder pain. Range of motion there is good and the pain has decreased since he stopped using the walker. Recommendations are to stop using the knee brace, stop using the cane unless he is on uneven surfaces, continue physical therapy and add strengthening. Start physical therapy for the left shoulder. Dr. Yacisen said he is almost sure Mr. Abraham will not need surgery but will know more at the 90 day point.

After 90 days in the hospital, Andy Wirth regained use of his arm. Undaunted and determined, Andy faced insurmountable odds against a full recovery. He commented, “My metabolism had changed. I didn't take two steps back I went