Post Operative Instructions
Open Debridement for Medial Epicondylitis of the Elbow
During this procedure, a small incision is made over the Medial (inside) aspect of your elbow, and the abnormal tendon of the forearm muscles is debrided (removal of unhealthy tissue) from it's origin along the medial epicondyle (bony prominence over the inside of the elbow).
You have been placed in a sling for comfort. Remain in this sling until seen in the office. You will probably use the sling for a short period of a week or so, just until you are comfortable. You may use it at night if you roll on it in your sleep, or when you're out and about in public, to avoid inadvertent contact.
A compressive dressing has been applied to your elbow. Keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable after 48 hours. You can best keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet.
Some degree of swelling of your forearm, hand and fingers is normal. Swelling can be decreased by elevating your elbow. Swelling can be further controlled by use of ice or cold therapy directly over the surgical site. Ensure there is some fabric such as a washcloth, between the cold and the skin to prevent frostbite. Place a bag of ice or package of frozen vegetables (which nicely conforms to) the surgical site, 20 minutes on and 20 minutes off.
Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most "dependent" part of the extremity. An evolving bruising of the forearm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.
A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.
You may use the elbow based on the degree of your comfort. Do not lift or carry anything heavy until you are released to do so. You may drive when you have good control of your arm and off narcotic pain medication. You may eat a regular diet. Drink plenty of fluids.
Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.
Pain Medication Tips:
- Do not drive while taking pain medications.
- Do not drink alcoholic beverages while taking pain medications.
- Pain medication should be taken with food as this will help prevent any stomach upset.
- Often pain medications will cause constipation. Eat high fiber foods and increase your fluid if possible.
- To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.
You should be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.
Your post-operative appointment is scheduled on: _______________________________________________.
If you need to verify or change your post-op appointment, please call 703-277-BONE (2663).
Physical therapy is usually delayed for about six weeks to permit the tissues time to heal and avoid injury. You may or may not require formal therapy. If you require PT we will be glad to help you in identifying an appropriate therapist if you need assistance.
IN CASE OF EMERGENCY
You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:
- Fever greater then 101.5 degrees F
- Numbness, loss of color or coolness in hand
- Severe pain unresponsive to narcotic medication
- Excessive bleeding or vomiting
- Difficulty breathing or shortness of breath – Call 911