Surgery for bursitis on the elbow
introduction
An operation for bursitis in the elbow is usually not necessary, as the inflammation can often be treated conservatively. However, if the therapy shows no effect or there is a bacterial infection of the bursa, surgery is often recommended. The more detailed information about the surgery itself and the follow-up treatment can be found in the course of this article.
treatment
The bursitis on the elbow, if it is chronic, is initially treated conservatively. To do this, it is important to immobilize the affected joint, which can be done by applying a cast if necessary. Above all, a strong pressure load by leaning on the elbow should be avoided. In addition, the administration of painkillers such as ibuprofen or diclofenac and anti-inflammatory drugs is useful. A puncture of the pus that has built up in the bursa from a bacterial infection and an injection of cortisone to reduce inflammation may be considered. This therapy should be carried out for 2-3 weeks.
Surgical removal of the bursa is the method of choice if the inflammation does not improve or worsens, as well as bursitis after acute trauma or recurring inflammation.
However, the causes of the inflammation and the risk factors such as occupational stress or anatomical abnormalities such as protruding bones, which can lead to slight irritation of the bursa, should not be ignored.
Anticoagulant medication should be discontinued prior to surgery to minimize the risk of bleeding in the surgical area. It is also important to give an antibiotic once before the operation to minimize the infection. After opening the skin and the subcutaneous fatty tissue, which is usually very thin on the elbow, the surgeon tries to bluntly detach the bursa and remove it without opening so as not to bring any infectious material into contact with the surrounding tissue.
With peracute inflammation, however, the infection has already spread beyond the bursa. There is a risk of sepsis (blood poisoning), so this is an urgent indication for surgery. In the case of an acute inflammation that is limited to the bursa, if it cannot be completely removed, it is opened with an incision and rinsed daily. In addition, antibiotic therapy and, if necessary, the installation of a vacuum pump is indicated. This cleans the wound and is connected via suction to an apparatus into which the wound secretion is drained. Once the inflammation has healed, the bursa can now be safely removed in a second operation.
Read more on this topic at: Course of surgery for bursitis on the elbow
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Aftercare
After the operation you will already be in the operating room Splints on the elbow joint created to ensure immobilization. Alternatively, one can also do one for a period of one week plaster be created. Also is a Thrombosis prophylaxis, one anti-inflammatory and analgesic therapy and the regular follow-up examination important. About The arm should be immobilized for 2 weeks and not put too much strain. After this time, the sutures of the surgical area are pulled. If the doctor does not find any further complications or signs of infection, the elbow can now be loaded again. For particularly arduous sports or work for the arm, however, you should wait up to 6 weeks before full activity.
Risks and Complications
The bursa has an important role in the elbow joint. He regulates the enormous pressure load on the joint and thus protects the bones from strong mechanical compression. After a surgical removal, this regulatory mechanism is missing, which can damage the joint. In addition, a surgical and thus invasive procedure inevitably leads to Scarring. These are aesthetically disruptive and can also impair joint function. A Reduced mobility cannot be ruled out here. In addition, the surgical procedure can lead to too Nerve lesions of the neighboring nerve tracts come. In rare cases this can result Paresthesia, Numbness or Loss of function of individual muscle groups to lead. Also a Bruise in the elbow joint can occur after surgery and is not uncommon.
In addition, it can be used for intraoperative bleeding come because the surgical area is very well supplied with blood. However, low and controlled bleeding is not a concern and can be compensated for by the body. A complication caused by a Hemorrhage in a muscle box, and thus an area limited by a muscle fascia, can occur Compartment Syndrome called. This leads to a dangerous rise in tissue pressure within the compartment. Consequences are Nerve lesions, Tissue and organ damage. If there is any suspicion of a Compartment symdroma rapid surgical splitting of the fascia is indicated. The operational opening of the skin and the subcutaneous tissue can penetrate bacteria get into the wound area and become infected. This risk is increased by the pre- and post-operative antibiotic therapy minimized.
Prevention
Chronic bursitis, in particular, can be avoided by taking a few preventive measures. Besides the Clarification of a previous inflammatory disease or anatomical disruptive factors can the Wearing bandages lead to a relief of the bursa, which minimizes the risk of inflammation. If bursitis of the elbow recurs again and again, should Highly stressful sports such as tennis are paused or be abandoned. Also an overstimulation of the bursa constant propping up can be avoided. In such extremely stressful situations a upholstery help relieve some of the pressure on the bursa. If it is not possible to omit the stressful positions, should frequent breaks be performed. There is one Immobilization and extension of the elbow important to take the pressure off the bursa.
Symptoms
At a Bursitis of the elbow it comes to Redness and swelling of the affected area, usually the elbow is additional overheated and the patient has Pain when exercising or even at rest. The bursa can be felt as hardened and bulging; depending on the cause of the inflammation, it can, too pus contain. The swelling and pain cause Restricted movement of the elbow joint.
Diagnosis
The Palpation of the elbow and the any signs of inflammation are already pioneering the diagnosis of bursitis. By a Ultrasound examination can this be saved. Here shows increased fluid or where appropriate Pus inside the bursa. When the inflammation is on acute trauma should also be another X-ray of the elbow be made to rule out bone splinters and the like that irritate the bursa.
