TOTAL ELBOW REPLACEMENT
Therapy Guide

• Commonly for RA to reduce pain and improve ROM & function
• Dorsal longitudinal incision
• Bulky dressing with POP backslab
• Elevation of hand and arm for 2 weeks
• Early hand and wrist ROM exercises
• POP backslab removed at 3 days and replaced with thermoplastic forearm-based extension splint.  To wear at night and for comfort for 6 weeks
• No active triceps for 6 weeks

Exercises – To be done every hour

• Full fist to fully straight hand x10
• Wrist up and down x20
• Active elbow flexion with passive extension (i.e., eccentric biceps) x10
• Sustained elbow flexion with overpressure using other hand x3 mins
• Sustained elbow extension with overpressure using other hand x3 mins
• Supination with elbow at 90° tucked into side
• Scar massage x 5 minutes once wound has healed
• Use weight to help stretch into extension and hold up to 5 minutes

Look out for

• Inability to actively straighten arm (triceps may have pulled off)
• If poor ROM then contact Hand Therapy at the RUH – may come in for intensive Physio
• Infection – send to GP urgently for antibiotics and refer back to next clinic
• Numbness or wrist drop.  Can be radial or ulnar nerve disruption.