If you have had awake elbow surgery or a general anaesthetic combined with a regional nerve block you may have minimal pain or discomfort in your elbow when you are discharged from hospital. Blocks should last up to 24 hours after elbow surgery. We usually send you home with tablet painkillers.
The first night of your elbow surgery we advise taking your painkillers before going to bed and first thing the next morning when you wake up so that you have good pain relief on board and the block wears off slowly rather than suddenly.
If you have had surgery for a fracture we recommend avoiding anti-inflammatory pain killers as they can slow down fracture healing.
For added pain relief an ice pack applied to the shoulder can be helpful. You can ice the shoulder as much as you want with each icing session going no more than 20 minutes at a time. You can purchase a useful ice pack here. (please note we have no connection to this company)
Sleeping After Elbow Surgery
One of the common problems after elbow surgery is swelling of the fingers and the hand. After surgery, because of swelling at the elbow the circulation is slowed and fluid can collect in the hand overnight as you sleep.
It is important to have the hand elevated in bed after elbow surgery. To do this we recommend sleeping on your back with your elbow at your side resting on the bed and the hand resting on a cushion at your side. This will cause a gradient from the hand on the cushion to the elbow on the bed and gravity will help pull the fluid out of the hand overnight. If you wake up throughout the night try to move your fingers and wrist as this will help with swelling also.
Please see this video on how to elevate your hand after surgery to avoid swelling:
To help with pain please take painkillers before bed time. You may also use an ice pack on the elbow at night before bed time to help with pain and swelling before going off to sleep.
Most patients will be sent home from elbow surgery with a temporary shoulder sling (collar and cuff). This sling is meant to support the arm overnight as it is
usually floppy from the regional nerve block. The next morning when the arm comes back to life, if instructed by us, the collar and cuff should be removed and thrown away, and exercises and use of the shoulder, elbow, wrist, and hand should start straight away.
If you have had some types of complex elbow surgery you may be sent home from surgery with a more long-term surgery sling called a polysling. After the operation we will tell you how long the sling is to be worn for.
Polyslings can be confusing to adjust so please watch this video on how to adjust your shoulder sling:
Rehabilitation After Elbow Surgery
Getting your elbow moving is a key part of elbow surgery recovery. The rehabilitation of your elbow depends on the operation you have had. We would have discussed with you the expected post-operative rehabilitation before the operation in clinic and on the ward and we will confirm this with you after your surgery.
Almost all patients having elbow surgery will require physiotherapy post-operatively. You will need to arrange the physiotherapy to start when we advise you, and will need to get approval from your insurance company to cover the costs of the physiotherapy.
After elbow surgery the main issue is stiffness in most cases we will instruct you to start using the elbow as soon as possible after the nerve block wears off and the arm comes back to life. Initially you will most likely be in a bandage which will restrict your movement. We will tell you when you can reduce the bandage and start full movement and we will tell you about any restrictions to movement that you should observe.
This video shows you what movements you can do in the bandage, how to remove the bandages, and how to start full movements of the elbow after the bandages are removed:
If you have surgery for an elbow dislocation or elbow ligament repair we will ask you to do supine active elbow extension exercises against gravity. This important exercise helps you to work on range of motion while keeping the elbow stable. It can be done in or out of the post-operative elbow bandage. Please see the video below for instructions on how to do this important exercise:
After elbow surgery we suture your wound, secure it with steri-strips, and cover it with a dry wound dressing (usually transparent with a white pad in the middle). An outer pressure dressing or bandage is applied over the wound dressing to reduce post-operative haematoma formation.
We will tell you when to remove the outer bandages.
The inner wound dressing should be kept clean and dry for two weeks. At two weeks we see you in clinic to remove the wound dressing and the steri-strips, and we either trim or remove your sutures. When the sutures are trimmed or removed there are tiny holes in the skin which take 24 hours to close.
In order to keep the wound dressing clean and dry until the follow-up appointment we don’t recommend showering until the day after your sutures are trimmed or removed. If you do want to shower, once the bandages are removed you can cling-film the elbow to ensure it is water tight and the dressings remain dry during showering.
Getting the wound wet or removing the dressing too soon without re-covering the wound can lead to wound infection.
When Can I Drive After Surgery?
You cannot drive with a sling, bandages, or dressing as these could make you unsafe or invalidate your car insurance. After we give you permission to remove your sling and dressings, the elbow can still be a bit painful and stiff so usually it is not possible to drive safely until a few weeks after surgery. If we have placed restrictions on how much weight you can put through your arm then you may not be able to drive until those restrictions are removed as your elbow wont be strong enough to control the steering wheel.