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capitellum fracture
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capitellum fracture

on oct.29 .07 i was at work and tripped and fell.extending my arm to break my fall .the result as it turned out was a fracture to the capitellum.from the begining i told my doctors that in addition to the pain in the elbow that i was feeling different pains in my forearm and wrist mostly a popping in the forearm. i was told that it all stemed from the fracture....on nov 19 . i had surgery to remove 'bone fragments"from the elbow .its now jan 24 and still have extreme pain in the elbow and now that i try to use the arm the popping is almost constant in the forearm depending on how much pressure i try to use it goes from a stingging sensation to a numbing of the forearm then the eblow swells up again.now the doctor tells me that i may need more surgery......can someone tell me in plain english what could be going on in my arm.......thanks
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14 Comments Post a Comment
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Avatar_n_tn
Hi Frank,
Pain, tingling and numbness are signs of neuropathy. Neuropathy can be involving single nerve or many nerves which is called as mono-neuropathy or poly-neuropathy.
The cause for neuropathy can be due to nerve entrapment or nerve compression or nerve irritation.
In your case it can be due to nerve irritation and also can be due nerve compression. The involved nerve here could be ulnar nerve or median nerve.
Nerve irritation due to fracture fragments still persisting and nerve compression due to swelling could be the pathology.
The fracture fragment in capitellar fracture is intra-articular and requires treatment and reduction to re-establish for normal elbow motion.
Difficulty arises from the various sizes of the fracture fragment and from the amount of suitable subchondral bone that is present to achieve stable fixation and to allow early elbow motion.
Failure of adequate intervention may result in an incongruous joint, as well as in stiffness, instability, and chronic pain.
Keep me informed if you have any queries.
Bye.
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Avatar_f_tn
i am now being told that the popping is a result of thr radius bone being unstable.........and that an elbow specialist will needto be consulted and that more surgery will be likely.......the arm as it is now is useless........do you think it will every be right.........and what could they be thinking about on fixing it ...if they can
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Avatar_n_tn
Hi,
How are you feeling?
I think it could be likely that your radius head is popping out and not the Capitellar fracture fragments depending upon the distribution of pain and numbness along the elbow joint.
Can you tell me where the distribution of pain and numbness along the elbow is and forearm?
What about an imaging study? Is it been done? Is yes, what is the result?
AP and lateral radiographs of the elbow usually are sufficient for making the diagnosis and for assessing reduction.
Pain, swelling, and decreased supination or pronation of the forearm is the main symptoms of the traumatic dislocation of Radial Head.
If the injury is >7 days old, open reduction may be necessary if closed reduction is unsuccessful.
In the unstable reduction, a prolonged period of immobilization may be necessary to allow for fibrous tissue to confer stability.
Occasionally, the immobilization may be augmented by a Kirschner wire across the radio-capitellar joint.
The prognosis is excellent for a functional ROM of the elbow, forearm, and wrist, particularly in patients <30 years old.
Keep me informed if you have any queries.
Bye.
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Avatar_f_tn
let me start by saying that im 48 years old..........the pain is on the thumb side of my forearm.....the stinging pain starts right above my thumb at the wrist and goes up about 3 inches...from there up depending how hard it pops i get the numbing.......at this point i can feel the bone moving around my forearm all the time......the swelling and  the tightening burning feeling is around the upper forearm and elbow.......my pysical therapist is afraid to work on my arm thinking they may make it worse......my doctor is waiting to see if the capitellum scarring over would help.........but its only been getting worse...its been 3months since the injury and i havent even tried to put any kind of pressure on the elbow due to the popping  .......justto note...that most of the time it pops its with the palm of my hand facing downward..........ive requested an mri and was told that it wouldnt show the problem  ???????...........so i sit and wait which is starting to get depressing...............should i start looking for another doctor  or wait on this one???
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Avatar_f_tn
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Avatar_n_tn
Hi,
How are you feeling?
Your symptoms of pain, tingling and numbness on radial side, popping upon radial side with your palm facing down suggest that in pronation you are having popping and also numbness near elbow.
This symptom suggests that you are having either radius bone fracture or radial nerve is getting compressed during the movement.
I think x-ray and MRI in pronation and supination will help in finding out the cause.
I think you can change the doctor and get another orthopaedician to see and re-assess your case.
Keep me informed if you have any queries.
Bye.
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Avatar_f_tn
just got back from docs app.they refered me to a specialist at the hospital for special surgery......they said that the ligaments around the radius bone may need to be reconstructed...........what does this surgery entail exactly???........and how long is the recovery time till i can use my arm for work??????????????????????
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Avatar_n_tn
Hi,
I am not sure what have they diagnosed with. It is important to see what diagnosis is been put down to decide about the approach.
As I mentioned in my earlier post there would be some weakness of radius bone during pronation which could be made sure only on examination.
I feel they want to reconstruct the support of radius bone, ligaments and muscle too.
In case if there is any loosening they would stitch ligament in such a way that it would be able to support the bone in any movement.
You can use your arm, but not your forearm.
Prognosis is good and you would be able to function within a week’s time.
Keep me informed if you have any queries.
Bye.
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Avatar_f_tn
its now mar 22........and i have seen three more doctors ...new xrays and an mri were done ........results ..........osteochondral fracture of trhe capitellum with fragment in place...........now thata funny to me cause i had surgery to remove that fragment .............anyway its still there ..........mri shows that there is also damage to the radial head ...so instead of the two sufaces working together they are grinding and catching each other ..thus resulting in the snappping that i feel causing great pain...............now i have a choice of three different options that i can chose from........the first one is to do nothing and live with it.......thats actually not an option for me.................the second is to try to repair the surfaces which can take up three or four surgeries and the outcome would not be certain......the third is to have the fragment and the head of the radial bone cut out....im asured that this will fix all the symptoms..........ive chosen the last one ..........ive also been told i have what looks like the begining of tennis elbow...............my question is three fold........first ..have i chosen corectly???.......second....has anyone had this done .......third.........does anyone know that is the onset of tennis elbow the result of my injury.......thanks in advance for any feedback...............PS.....to any MD responding.......what is the heal time of such a surgery........
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Avatar_n_tn
hi...im gettin ready to do the same operation that u did....i need to know how u r feling as of now? Is it any better? Are u still of work? Whats happeneing with it? Thanks for ur reply because im really kinda scared about all this and i need to get back to work.
Deb
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Avatar_f_tn
Hi I had an accident on March 10 and doctors diagnosed it as Capitellum fracture(Radial head), i was operated upon it and a Hebrew screw was fitted. After the cast was removed i am getting physiotherapy done. Its almost been 3.5 months(of physio sessions) and still there bent in my hand, its not straight. Can some one tell me how much time does it take to recover from such kind of fracture and will i get full range?
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