Post-operative rehabilitation (developed in conjunction with Melbourne Hand Therapy)

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It is vital that the triceps tendon be protected after surgery and during the healing phase. Post-operatively, the elbow will be immobilised for the first two weeks with a back-slab applied.  There will be an incision on the back of the elbow with sutures holding it closed and it will be kept dry with a water-resistant dressing. To ensure a full recovery, all bandages and dressings must remain intact and dry until the first post-operative appointment with Kemble. During this time, a plastic bag tied above the elbow can be used to prevent the arm from getting wet during showering or, alternatively, a one-handed bath can be taken. Kemble will review the wound and advise as to when it is safe and practicable to get it wet.

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Two weeks post surgery:

• Finger, wrist and gentle assisted/supported shoulder movements will commence as soon as possible to maintain movement and avoid stiffness;

• The arm should remain as elevated as much as possible, particularly in the first 5-7 days, to reduce the risk of swelling.

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Weeks 2-6 post surgery:

• The post-operative back-slab and primary dressing of the wound will be removed;

• Tubigrip (or similar) will be applied to the elbow to reduce post-operative swelling;

• Scar management will commence;

• Active elbow flexion and passive elbow extension exercises will begin. These exercises are undertaken in a seated position with the arm supported on a table and the shoulder stable at 70-90 degrees. No active triceps extension or passive elbow flexion will occur until the 6 weeks post-operative appointment;

• Hand, wrist, and shoulder exercises are to continue;

• The sling should continue to be used when not performing exercises;

• It is still too early for any functional use of the arm.

 

Weeks 6-12 post surgery:

• All active and passive range of motion exercises to prevent stiffness/contracture will begin;

• Sling no longer needs to be used;

• Light functional use of the arm can commence however no weight bearing through the arm or eccentric contraction of the triceps muscle should occur.

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Weeks 12+

• Strengthening and conditioning exercises of the elbow and shoulder should continue;

• Weightbearing conditioning exercises will commence

• Work should continue if necessary, to correct any range of motion deficits.

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Return to activity

• Because eccentric contraction and loading of the triceps must be avoided until 12 weeks post-surgery, functional loading and sports must be avoiding throughout this phase.

• At this stage, a therapist will direct and guide a continued strengthening program and help determine a return to sport and/or loading activities schedule which will be based on individual recovery needs)

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General post-operative things to be aware of:

• Some tingling, numbness or weakness following the procedure is normal. This is often a result of the nerve block performed before surgery to help manage pain, or the local anaesthesia injected postoperatively. The effects will wear off in the first day or two.

• If drainage from the wound continues after two week, contact Kemble

• If sudden snapping sensation in the back of the elbow is experienced, please contact Kemble, as this may indicate rupture of repair.

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Possible Complications

• Ulnar nerve irritation or injury;

• Elbow joint stiffness/Triceps contracture;

• Re-rupture of tendon.