Tuesday, June 25, 2013

Elbow update (or, "Why yes, I do have a screw loose", or, "Fear my mighty triceps!")

For those just joining us, here's a brief recap on the elbow situation:

Ten weeks ago, I broke my right elbow (olecranon) at the Zumbro 17 mile trail race.
Heading into Aid Station #1 with a busted elbow.
No bones were sticking out, so I kept going.
(Photo: Todd Rowe)
My surgeon has since said things like, "It was kind of shattered." And, "It was a bad break."
But she fearlessly reassembled it, throwing out one bone fragment that couldn't be pinned in place, and holding the rest together with a big plate and six screws.
Much better.
Since then, I've run with it in a cast, then an articulated brace, then nothing at all.
And decorated the brace with race bling.
I've also been doing physical therapy -- first active range-of-motion, then some passive range-of-motion and resistance work with Therabands. I'm slowly gaining mobility in the elbow.
What, doesn't everyone graph their active range of motion?
Last week, I noticed a bump by the point of my elbow. It felt like the head of one of the screws, the one nearest the elbow. I figured maybe swelling had gone down in my elbow so now I could feel the hardware. (I could feel the plate, too). But it seemed really close to the skin. I would occasionally bump it into things, which was painful.

I mentioned it to my physical therapist at last week's appointment and she was concerned. (More concerned than I was). She got me in for an X-ray that morning and, sure enough, the screw is backing out.
Yes, I've got a screw loose.
A CT scan yesterday morning confirmed that, and showed some more bad news: one of the screw tips is in my joint space now. Not a good place for a piece of metal. The good news? The bone looks healed.

My surgeon called this morning (while I was running) to discuss the situation. She thinks my triceps may be pulling on that proximal screw and pulling it loose. Fear my mighty triceps! Anyhow, since the bone is healed and the hardware is wandering into bad places, she advises removing it sooner rather than later.
"Okay," I said. "How soon?"
"Well, I've got time in the operating room tomorrow, or Friday. Which one works for you?"

Well, that's pretty soon. Surgery's scheduled for Friday morning. Hardware out, and a closed-joint mobilization (basically, taking the elbow through its range of motion under anesthesia). Should be a quicker and simpler surgery than the first one, and result in no cast, no brace, just a gauze bandage. Then moving the joint as soon as possible -- PT early next week.

I've got high hopes that this will keep my rehab on track and maybe even improve my joint mobility. And if nothing else, I get rid of this big lumpy screw sticking out of my elbow. And that's its own reward.


  1. Funny, but in my second to last surgery, I had one of the big titanium screws back out of my knee, with the head as a visible bump just below my knee cap. Hurt like a hell when I bumped it into anything. Strangely, it stopped moving eventually and remained stable for several years.

    1. Ow ow ow. And I bet you discovered, like I have, just how OFTEN you bump your knee/elbow into stuff!