The elbow is a complex joint of the upper limb formed by the articulation of the long bone of the upper arm or humerus and the two bones of the forearm, namely, radius and ulna. It is one of the important joints of the upper limb and is involved in basic movements such as flexion and extension of the upper limb and rotation of the forearm.
The elbow joint is supported by the ulnar collateral ligament, radial collateral ligament and the annular ligament. These ligaments provide stability and strength to the elbow joint.
The elbow joint also has the attachment of the common flexor and common extensor tendons. These groups of muscle assist in rotational movement of the forearm as well as the movements of the wrist and hand.
The common conditions affecting the tendons around the elbow joint include tennis elbow and golfer’s elbow which result from an overuse injury to the tendons or result from repetitive activities such as sports, mechanical activities or weight lifting.
The ligaments around the elbow may be injured secondary to a sprain, rupture, trauma or any accident. The sprain or trauma may result from repetitive stress, overuse or a direct injury.
Symptoms of Elbow Injuries
The common symptoms of injury to the elbow joint and its surrounding structures include swelling and pain, which may extend from the elbow to the forearm and palm and be aggravated by movements of the wrist. Sometimes, instability of the joint may also be seen.
Tendon Repair Procedures
The repair of the damaged tendon is broadly classified into two types- tendon debridement and tendon release.
This procedure is commonly used in the management of tendinitis. In this procedure, the surgeon removes any damaged tissue from the tendon and cleans the tendon.
It is the most commonly used surgery for tendon repair. In this procedure, the surgeon locates the attachment of the extensor or flexor tendon on the elbow and splits the damaged tendon as well as removes the scar tissue or other overgrowth, around the tendon. Sometimes, the loose end of the tendon may be sutured to the surrounding connective tissue (fascia).
Complications of Tendon Repair
Common complications of tendon repair surgeries include infection, injury to the adjacent nerves and blood vessels, and a loss of strength or flexibility of the elbow joint.
Rehabilitation after Tendon Repair
The success of the surgery depends on the post-operative rehabilitation program which includes the use of a removable splint immediately after surgery as well as ice therapy, electrical stimulation and massage for reducing pain, swelling or muscle spasm. Isometric exercises, strengthening and range of motion exercises may be useful for long term rehabilitation.