One week at home and it’s time for the first elbow cast removal. The olecranon fracture has been kept safe from injury, but now it’s time to look under the cast, and see how the wound is healing.
In the first week at home I’ve tried to keep up with the physio requirements, which are slightly hard when in the cast, if only due to the angles you CANT assume.
One issue that has been mildly worrying, is on various movements, there is quite a discomfort at the mid point of the arm, but also a tearing sensation – like someone ripping sticky tape off my arm. Making me wonder if actually I’ve over stretched things and done some damage under the cast – time to find out with the elbow cast removal
When I crashed, I was wearing a Castelli Alpha Wind jacket – which is absolutely amazing by the way – which whilst it didn’t provide enough protection to prevent the elbow fracturing, I was impressed that the jacket itself didn’t damage hitting the floor, unlike my bib which was completely shredded. In spite of the jacket, I did still sustain an abrasion to the elbow, meaning the need to have the cast removed one week after the surgery to redress the graze and review the operation cut to make sure there is no evidence of infection.
The unintended benefit of needing to review then skin meant we could see if there was a lot of bleeding under the cast, and also go through cast removal and replacement – which was brilliant, as at one week, it was just beginning to become slightly itchy, particularly as a result of the effort required in doing some of the physio exercises.
One of the useful pieces of advise I was given about improving fracture healing, was to keep the hand active, and get the blood pumping to the arm. This will help get nutrients to the fracture site, aid the removal of excess fluid and waste products from the injury.
One. Of the best ways to do this, and reduce the likelihood of having a residual weakness in the hand, through a grip strength exerciser.
A good proportion of the muscles involved in the control of the grip in the hand, are located in the forearm, not then had itself. This, pumping the hand repeatedly with grip exercises, activated the muscles around the elbow helping pump the fluid out of the arm. I’ve found this to be an effective adjunct to the PowerBall I’ve also been using
Thankfully these muscles do not cross the elbow itself, thus using them has no effect on the elbow, and can be done pain free.
Whilst the reduction of swelling in the arm is great, it does have the slight problem, that the plaster cast becomes loose. By the time it came to have the cast removed at the end of the first week, the arm had managed to clear sufficient fluid that I could put two fingers down the cast. The problem with this is it allows the potential for the elbow to move, and stability is very important for the first few weeks to promote fracture healing.
After the cast removal, I felt so vulnerable!! The cast holds you very snugly, and works as a very effective pain relief – removing the cast, even for a short period, feels very…uncomfortable, frightening almost!
After the cast removal and being able to see, after cleaning, my arm was actually very reassuring, as we could see there wasn’t acres of dried blood along the arm, in fact it was a little disappointing!
The wound, was healing nicely, and showed no signs of infection
New cast, new angle
In putting the new cast on, we adjusted the angle of the elbow, to make both living and sleeping that little bit easier, which was a huge benefit
In the photos I’m in a rather unattractive grey gilet, the reason being basically if it has a sleeve, I couldn’t get my arm down it. So I’ve been stuck wearing t-shirts, and a gilet, which sometimes doesn’t keep the winter cold out as much as I’d like!!
At this point I was given a further sick note for four weeks, needing another week before the next cast removal and wound check, but best of all told by the consultant I could sit on the turbo trainer, as long as there was no chance of me falling. But running should be absolutely avoided still.
Although the consultant was happy for me to sit on the turbo, it would still be a while before I would have the confidence to do that!