The plaintiff, a pleasant sixty-five-year-old female, in good health sustained injuries when she tripped and fell on uneven parking lot pavement. Upon falling onto her flexed bilateral upper extremities, she immediately experienced significant pain in both elbows. Emergency medical services transported her to the Hospital, where she underwent evaluation in the Emergency Department. X-rays of the left elbow revealed a comminuted intra-articular distal humerus fracture, graded as 1 open with a small puncture site. The right elbow x-rays showed a comminuted fracture of the olecranon and a comminuted fracture of the radial head. It is worth noting that a comminuted fracture refers to a bone that is broken in at least two places, often resulting in fragmented pieces.
After careful consideration, the decision was made to proceed with an open reduction and internal fixation of both arms. The left arm underwent an ulnar nerve neurolysis, fixation of a small olecranon fracture, and an excisional irrigation and debridement of the comminuted distal humerus fracture. The right arm required a radial head arthroplasty, fixation of a coronoid fracture, repair of an ulnar collateral ligament injury, and ulnar nerve decompression. Throughout the postoperative course, the plaintiff encountered the additional complication of contracting COVID, which further complicated her recovery. To aid in her rehabilitation, the plaintiff engaged in comprehensive outpatient physical therapy aimed at restoring range of motion, strength, and overall function in both elbows. Despite these efforts, the plaintiff continued to experience persistent difficulties, particularly in terms of range of motion and pain in the left elbow. Consequently, the plaintiff underwent multiple procedures, including hardware removal, bone grafts, and joint contracture release, to address these ongoing issues. Ultimately, all remaining hardware was removed, and a total elbow arthroplasty was recommended.
Given the severity of the injuries sustained, the plaintiff will require ongoing orthopedic follow-up to assess and manage her persistent elbow pain and limited range of motion. Postoperatively, she benefitted from additional physical therapy specifically targeted at the left elbow, with the goal of restoring appropriate range of motion, strength, and function.
