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What is Open Elbow Surgery?

Open elbow surgery is an operative procedure performed to treat certain conditions of your elbow through a large, open cut (incision) in the skin using a scalpel.

It is a type of surgery where fatty tissues and muscle layers of the elbow beneath the skin are cut to expose the entire operative area. This will help your surgeon to have a full view of the affected structures or organs involved.

Conditions Treated by Open Elbow Surgery

Open elbow surgery is done to treat several conditions of the elbow. They include but are not limited to:

  • Tennis elbow - painful swelling and inflammation of the joint caused by overuse
  • Trauma such as open fractures, displaced fractures, bone dislocations
  • Cubital tunnel syndrome – compression of the ulnar nerve crossing the elbow
  • Radial tunnel syndrome - increased pressure on the radial nerve at the elbow joint
  • Osteoarthritis - degeneration of the joint cartilage due to age and activity

Candidates for the Surgery

The surgery is typically recommended for those who are: 

  • Incapacitated by a condition of the elbow
  • Not benefiting from conservative treatments 

Preparation

Your surgeon will advise you on the following prior to the surgery:

  • Stop taking medicines (if any) that could cause bleeding during the procedure 
  • Avoid food or drink of any sort after midnight, the night before the surgery
  • Quit smoking (if applicable) as it can slow healing and recovery from the surgery
  • Arrange for someone to drive you back home after the surgery

Open Elbow Surgery Procedure

Just before the surgery, a sterile drape is placed around the operative site after which you will be administered general anesthesia or a sedative to help you relax and make you sleepy. Numbing medicine may also be given to your arm to block pain all through the procedure. 

The skin around the operative area where the incision will be made is scrubbed thoroughly and an antiseptic solution is applied. 

During the surgery, an incision is made in the skin just above the bone over the outside of your elbow or at the side of the elbow to access the affected area.

Depending on the type of condition being treated, your surgeon will carry out the following:

Tennis elbow

  • The location of the tendon damage is identified and treated by way of any of the below methods: 
  1. The damaged portion is released by severing its connection to the bone.
  2. The Damaged portion is repaired using a suture anchored into the bone or by stitching it to other tendons.
  3. The damaged part is cut out and the healthy portion is reattached back to the bone. 
  • The underlying bone is exposed and a tiny piece of it is removed to stimulate blood flow and help the area heal faster.

Trauma (Fractures)

  • Broken bones are repositioned into their original place and surgically fixed with hardware such as screws or pins.

Cubital or radial tunnel syndrome

  • The tissue covering the ulnar nerve or radial nerve is cut to relieve the compression or pressure on that nerve.  

Osteoarthritis

  • The damaged parts of the joint are identified and replaced with artificial joints. 

Regardless of the condition treated, the incision is closed with stitches, one or more sterile dressings are applied and the arm is placed in a splint. 

Risks Associated with Open Elbow Surgery

As with any surgery, the procedure can lead to possible complications such as:

  • Severe pain, redness and infection in the elbow 
  • Injury to the nerves or blood vessels in the elbow
  • Swelling in the elbow that does not go away
  • Skin color changes and larger scar around the elbow
  • A feeling of loss or reduced strength and flexibility
  • The requirement of a second procedure (though rare)

After Surgery Care

After the surgery, you need to be careful not to injure your elbow again. Therefore, you are required to wear the splint for about a week. This will keep your arm still or immobilized. You are also advised to keep the wound and the dressing clean and dry.

Benefits of Open Elbow Surgery

The major benefits of the procedure include:

  • Reduces pain, increases blood flow and promotes better healing
  • Improves mobility - helps you move your elbow more easily and freely
  • American Academy of Orthopaedic Surgeons
  • American Orthpaedic Society for Sports Medicine