Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
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Excision of the Radial Head
Radial head excision is a surgical procedure that involves the removal of the radial head, the smaller bone of the forearm that forms part of the elbow joint, typically following severe trauma or due to degenerative changes associated with arthritis. Physiotherapy after radial head excision is essential to ensure the success of the surgery, restore strength and range of motion, and help achieve the return of full or near-full function in the affected elbow joint.
The radial head is shaped like a round disc and plays a crucial role in the movement of the elbow joint. It facilitates both flexion (bending) and extension (straightening) of the elbow, as well as pronation and supination (rotation) of the forearm. Consequently, injury or damage to the radial head can significantly affect all movements of the elbow. The main indications for radial head excision include:
- Severe trauma or fracture of the radial head that cannot be repaired
- Degenerative changes due to osteoarthritis or post-traumatic arthritis
- Persistent pain and loss of function after conservative treatments
- Mechanical blockage within the elbow joint caused by loose bone fragments
- Failed previous surgical interventions on the radial head
Radial Head Fracture
One of the indications for radial head excision is the treatment of a radial head fracture, which most commonly occurs from a fall onto an outstretched hand. This type of fracture causes pain and swelling around the elbow and can significantly limit movement and function of the elbow joint.
The treatment of a radial head fracture depends on the severity and type of damage. If the fracture is non-displaced (the bone remains in position), a conservative approach such as immobilisation followed by physiotherapy may be recommended. For displaced fractures (bone out of position), ORIF (Open Reduction and Internal Fixation) may be required to reposition and stabilise the joint using screws or pins. In severe cases, where the fracture is displaced or comminuted (three or more bone fragments) and the radial head is irreversibly damaged, radial head excision may be necessary. In some situations, the radial head can be replaced with an artificial implant to restore elbow function and stability.
Arthritis
Another indication for radial head excision is arthritis that has caused irreversible damage to the radial head. The ends of the bones in any joint are normally covered with articular cartilage, which allows smooth and efficient movement. In the elbow joint, arthritis can damage the cartilage of the radial head, leading to pain, stiffness, reduced mobility, and impaired function, particularly during forearm rotation. When the damage is severe, radial head excision may be necessary to restore mobility and function in the elbow joint. In some cases, the radial head can be replaced with an artificial implant to further improve elbow function and stability.
Surgical procedure for radial head excision
During radial head excision surgery, the surgeon makes an incision on the outside of the arm, carefully avoiding nerves and other important structures within the elbow. The radial head is then located and removed. The elbow joint is inspected, and in cases of inflammatory arthritis, the synovium (joint-lining membrane) may also be removed along with any damaged tissues or loose bodies that interfere with joint movement (elbow debridement/synovectomy). If needed, a radial head replacement using an artificial implant may be performed to restore stability and function, particularly when there is additional joint damage. In most cases, removal of an isolated radial head does not impair the overall function of the elbow joint. The surgical wound is then closed with stitches or sutures.
Physiotherapy following radial head excision surgery is essential to ensure the success of the procedure. It helps to prevent future complications and facilitates the return of full or near-to-full strength, stability, and function in the elbow joint. A structured rehabilitation programme is key to restoring mobility, muscle control, and overall upper limb function.
Symptoms after radial head excision surgery
Immediately following radial head excision surgery, you may experience pain, swelling, and stiffness in and around the elbow joint. You may also notice temporary instability, particularly if a radial head replacement implant was not required. Short-term loss of function, mobility, and range of movement in the elbow is common. Your elbow will be covered with a thick bandage, and you will be provided with pain management modalities. It is important to keep your elbow elevated above chest level for several days to minimize swelling and throbbing. A removable cast will be provided, and a sling should be used for protection and support during the early stages of recovery. Physiotherapy should begin as soon as possible after surgery to restore function and strength. You will not be able to drive until you have regained full and painless range of motion in the affected upper limb.
Physiotherapy after radial head excision surgery
Physiotherapy with acephysiosports.com after radial head excision surgery is crucial to restore stability, muscle strength, and range of movement in your elbow. A comprehensive rehabilitation programme will help you regain full or near to full function in your elbow while protecting against future injuries or complications. Recovery time can vary depending on individual factors, but commitment to physiotherapy will significantly improve your function and accelerate recovery. acephysiosports.com provides a personalised programme that targets your specific treatment goals, which will include the following:
- Restore stability in the elbow joint
- Regain full or near to full range of movement
- Improve muscle strength around the elbow
- Reduce pain and swelling in the affected area
- Enhance functional use of the affected arm
- Prevent further injuries or complications
- Improve coordination and control of the elbow joint
- Support a safe return to everyday activities, work, hobbies, or sports
1-4 weeks
During the early stages of your rehabilitation programme, acephysiosports.com will aim to control any pain and swelling you are experiencing in and around your elbow joint. At this stage, your physiotherapy programme will also focus on maintaining range of movement, flexibility, and mobility, as well as aiming to prevent deconditioning of your affected elbow and arm. Your physiotherapy will include:
- Pain and swelling management techniques
- Gentle range of motion exercises for the elbow
- Flexibility and mobility exercises for the affected arm
- Muscle activation and isometric strengthening exercises
- Education on safe use of the elbow during daily activities
- Guidance on posture and arm positioning to reduce stress on the joint
5-8 weeks
After radial head excision, your elbow will initially be unstable and weak, which can significantly impact function in your elbow and hand. Following the first month of rehabilitation, your physiotherapy programme will continue to focus on managing any remaining pain and swelling while progressing the exercises introduced in the previous weeks. The focus will be on increasing range of movement, flexibility, and mobility in the elbow joint. Strengthening exercises will be included and gradually progressed to help stabilise the elbow, with particular emphasis on movements such as forearm twisting (pronation and supination) due to the absence of the radial head. Your physiotherapy will also incorporate exercises to improve function in the hand, wrist, shoulder, and opposite arm, along with cardiovascular exercises to enhance overall fitness and endurance.
- Continued pain and swelling management
- Progressed range of motion exercises for elbow flexion, extension, pronation, and supination
- Strengthening exercises for muscles around the elbow to improve stability
- Functional exercises for the hand, wrist, shoulder, and opposite arm
- Flexibility and mobility exercises to enhance joint movement
- Cardiovascular exercises to improve overall fitness and endurance
- Guidance on safe movement and daily activity modifications
9-12 weeks
After three months of successful physiotherapy with acephysiosports.com, you will have achieved significant improvements in the function of your elbow and arm, with minimal or no pain and swelling. The focus of your physiotherapy will continue to be on regaining full strength and function in your elbow and arm. It will remain important to continue exercises that improve the strength and range of movement in your wrist, hand, and shoulder of the affected arm for additional support and to maximise overall function. Emphasis will also continue on activities that enhance everyday movements, while your programme will include exercises to increase cardiovascular fitness and muscle endurance, further optimising the function of your elbow joint.
- Regain full strength and function in the elbow and arm
- Improve strength and range of movement in the wrist, hand, and shoulder of the affected arm
- Maximise overall function and support for daily activities
- Continue activities that enhance everyday movements
- Increase cardiovascular fitness
- Improve muscle endurance to further optimise elbow function
Full recovery after radial head excision may take up to 3 months. The success and rate of your recovery highly depends on your commitment and adherence to the comprehensive physiotherapy programme provided by acephysiosports.com as well as the initial condition of your elbow prior to your radial head excision surgery.
Summary
Radial head excision is a surgical procedure that involves the removal of the radial head after severe damage following trauma such as a radial head fracture or as a result of degenerative changes associated with arthritis. Radial head excision surgery can provide significant relief from symptoms such as pain, stiffness, and reduced function in the elbow joint. Physiotherapy after radial head excision is crucial to ensure the success of the surgery, prevent the likelihood of any future problems, and help you achieve the return of full or near to full function within the elbow joint. A physiotherapy programme with acephysiosports.com offers the return of symptom-free, full or near to full function in the elbow joint. Commitment to a personal physiotherapy programme with acephysiosports.com will allow a more rapid return to everyday activities, work, hobbies, and sport. Call +65 81535374 for more information or to book an appointment.
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