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Physical Rehabilitation Medicine/hyperextended dislocated elbow and chip fragments

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Question
Hi. My son who is 11, hyperextended and dislocated his elbow during a wrestling match in January. It was put back in place within minutes. X-rays showed no fractures. It looked really bent and just not normal. We made weekly visits to an orthopedic surgeon and he did PT for 4 weeks. They said in April he was released to all activities but wrestling. To me it still looked abnormal, but who am I? And if you asked my son how it felt, he always pointed to his elbow where it looked funky and said ok, but if i touch here or bump it, it hurts.at one visit i asked about an mri and the dr said he didn't think it was necessary. He really hadn't done much of anything until this week which has made it 7 1/2 months since the injury. He was tackled in football yesterday and immediately lost feeling in his arm for a few minutes, and it was swollen. I took him to his pcp because the Ortho dr was off. He ordered an x-ray which showed something so they ordered a ct scan which showed he has a few bone chips. 1 being new the others old. Now we are referred to an pediatric orthopedic surgeon. What should I expect? How were the old chips not seen in 3 prior x-rays? Will he ever be ok to play contact sports again? Just want to prepare myself as to things I should ask. Thanks a bunch

Answer
First off I'm sorry for the delay!  Ok, the good news is that young kids heal fast. With or without surgical intervention. The bad news is he's probably going to have surgery again due to the likely risk of nerve injury (probably the ulnar nerve) to the extremity. I wouldn't be surprised.

I would ONLY take him to a board certified hand surgeon. Go to assh.org and search your area. Then call around to physical therapy clinics in your area and ask them who they recommend. Then go with the name you hear the most. The above is very important. I could tell you bad stories about general orthopedists and they're outcomes.

Let me know how it goes!!!!  

Physical Rehabilitation Medicine

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Brian Neville, OTR/L, CWCE

Expertise

I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!

Experience

10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Organizations
Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

Publications
RSD article

Education/Credentials
Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

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