nandystam

Hi all (hope this is the right place for this discussion)

Around 6 weeks ago I had a nasty fall on my bike onto bitumen which resulted in a (initially) non displaced left elbow fracture (radial head), possible tendon/bone damage to my left index finger and some muscular damage to my wrist (which has a plate from a previous fall).

The general advice was to get the elbow moving as soon as possible in order to avoid stiffness, so I did that. Somehow, the radial head is now displaced around 3mm. This doesn't seem like a lot but according to a lot of information on the internet, this puts it in the territory for surgery.

I saw a surgeon yesterday and his advice was that no surgery was required. A lot of poking and prodding around the elbow didn't get trigger any sudden response and movement seems good. I do get weird sensations down my forearm from time to time, but the surgeon seems to think this is probably reactions to the healing process. I also get weird sensations in my hand, which I think the surgeon thinks might be from damaged to the triangular fibrocartilage complex (TFCC) in the wrist.

The surgeon's recommendation is a course of PT.

I am curious to know if anyone else has had displaced fractures of the elbow that has not been corrected with surgery, and what the outcome was?

Thanks

grantelmwood

PT is a bunch of placebo voodoo nonsense.
If it heals naturally, people attribute it to PT
If it never heals naturally, people forget to admit that PT was a waste of time
I would get a 2nd opinion

stevel610 

I'm always a "if pt might work" I'd try that first. Just because an operation takes place doesn't mean the issue will be resolved.

Sueblue

I took a nasty fall on a bike trail yesterday. X-ray shows fracture of radial head. Told to ice and wear a sling. Wrist hurts too but that usually goes along with the fracture. Scraped up pretty bad but just grateful it wasn’t worse.

nandystam

Is it displaced or non displaced? The advice I got initially was to move the elbow as soon as possible in order to avoid stiffness. If I'd kept it in a sling or cast for a while this is probably what would've happened. It seems like a bit of a trade off, keep the elbow stable/fixed for a while and risk stiffness, or get it moving and risk the fracture displacing.

Since I already have a plate in the wrist from a nasty fracture about 6 or 7 years ago I've given that quite a nice whack in this fall.

Hopefully your elbow heals in place and without stiffness

KerryIrons

This statement certainly is nonsense. Physical therapy is just that. It can restore joint mobility and muscle strength and is necessary for a lot of people who don't have the presence of mind and body to actively recover from an injury or surgery. As my doctor told me, recovery from an injury like this is 90 % the patient and 10% the surgeon. Your claim is a complete misrepresentation of what PT is.

rsbob 

Surgery should always be a last resort. There is always a certain amount of risk associated with it, including infection.

My recommendation is see and do the PT. Time hopefully take care of the other issues as you heal. If not, you will have the surgery as an option. Besides, how many surgeons don’t recommend surgery?

Iride01 

6 weeks might be too soon to be fully recovered. If PT was recommended you need to do it. No matter how silly you think it is.

Your doctors decision on whether or not anything else is required for your recovery will partly depend on him/her knowing whether or not anything you do is giving you issues. Like riding your bike.

Of course there might be things that can be done with how you have things set on your bike to relieve some of your issues. But that will likely need to be someone that can see you and your bike in person and knows enough about bike fit to actually do something. Not just regurgitate formulas and numbers along with old witticisms and rules of thumb.

rumrunn6

can't speak to the specific injury but maybe sharing a little personal info might be helpful
I took a hard fall on a shoulder, 1 dr visit, 1 set xrays, 1 pt visit. I gained info from the dr, xrays & pt person
performed recommended pt on my own. recovery seemed to progress as it should. 16 months later it's not the same as before the fall, but I'm doing just fine
be a good patient, do what the ppl w/ education & training tell you to do. try not to fall on it again, for at least a year
have follow-up visits to be sure whatever you are doing is correct
maybe you don't need to go to (& pay for) weekly pt, but maybe you do, for a while until you get the hang on what to do, how to do it & what the healing process should be like
there's no magic wand for ortho injuries, especially for joints w/ moving parts
I had a broken long bone in my leg, which could have had surgery, but the surgeon opted for none. it was immobilized w/ a cast & it healed just fine, but I had to be a good patient & not keep twisting the break
good luck!

MoAlpha

Why don't you talk to another surgeon rather than wasting time here in Dunning-Kruger land?

GhostRider62

I fractured the radial head on a brevet about 30 years ago. The fracture was 45 degrees and the head shifted 5 mm down. I finished the ride but did not seek medical help for a few weeks, the surgeon said it was too late as the bone had started to heal. He said he would have pinned it had I sought care immediately. It really has not been bad over the years. When it is cold and playing golf on firm turf, I'll feel some pain.

I recently busted the humerus in 3 pieces and the elbow portion of it in 5 pieces. The surgeon had to saw my ulnar bone off to access the mess. 3 plates, one rod, and about 25 screws. They told me a full year to recover. I went to PT 3x/week. I did PT at home every day. I'd hardly say PT was a joke. It was pretty painful. I completed PT in 10 weeks and did a 200Km ride less than 4 months after my accident. My only complaint would be that they double billed Medicare but I can't blame them given how crappy they reimburse. The ER and Trauma center? The ER missed 5 broken ribs, broken scapula, and trochanter. Plain as day in the scan. The trauma center got the ribs but missed the scapula and hip bone.

Myself, I'd get a second opinion and would not hesitate to get it pinned if the Doc said it made sense.

indyfabz

I’m glad I was unable to seek advice from this forum before my recent heart surgery.

indyfabz

It recently got me walking again and home from rehab after spending more than 2 months without taking a step. I had more sessions in-home. I nearly cried after completing my first walk around the block with the help of a walker and the encouragement of my therapist.

Sounds like you could use some therapy of a different sort.

squirtdad

Wrong and terrible advice. (second option is not bad advice though(

PT is critical in regaining function after many joint and bone injuries.

MoAlpha

You dodged a hail of bullets there for sure.

3alarmer 

...I will most cheerfully admit that I know little or nothing about orthopedic injury, other than as a recipient of said injuries. I look forward to your immediate and sincere apology.

MoAlpha

Have you offered an opinion on the advisability of surgery in this case?

Iride01 

Might be more of a misery loves company type of post.

squirtdad

Point made about not 100% trusting ER.

I did an over that handle bars (kool stop brake pads really work well) when a car pulled in front of me in a parking lot.

still hurting next day, of to ER.... no fracture they say

still hurting a week later off to my ortho guy, yep fracture at ops of radius, already healing to much to do anything like surgery and he was concerned about risk vs marginal gain due to all the nerves in the area

result is even after PT (which gave me about 80% more extension than I had) I can't extend that arm fully and every now and then I get nerve impingement causing pain and weekness.

ymmv but seeing a specialist soon after ER is a good idea

3alarmer 

...no. But I am a part time resident here (no green card, but still a member).

I see two problems with this thread topic. First, it's in the "general" forum. General forum is generally filled with people of limited specific experience, generalizing their expertise to cover everything, as you have pointed out already. Second, and more importantly, everyone now gets their definitive medical advice from Chat GPT, like the Bing search engine, or one of those other AI large language models, like Google Bard. So your advice to get a second opinion is a reflection of how far behind the times you have fallen.

The Bike Forum free medical advice service is going to be severely impacted, unless the owners pony up for an AI.

It's the end of an era. Should auld acquaintance be forgot, and all that stuff.

soyabean

Gotta love seeking professional medical advice from strangers on the internet

jon c. 

It's not too late. We can surely offer opinions on the aftercare.

indyfabz

I’m waiting for someone to tell me I don’t need blood thinners. I’ve already learned that PT is a waste of time.

rsbob 

Am having hand surgery tomorrow on a non-cycling related injury. Am glad I didn’t consult the brain-trust first or I wouldn’t know what the heck to do. Hopefully will be back on the bike quickly.

Koyote

Nonsense.

Sense.