DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS:
Right elbow posteromedial impingement.
POSTOPERATIVE DIAGNOSIS:
Right elbow posteromedial impingement.
OPERATION PERFORMED:
Right elbow scope, posterior osteophyte removal.
SURGEON: John Doe, MD
ANESTHESIA: General.
ESTIMATED BLOOD LOSS: Minimal.
TOURNIQUET TIME: 45 minutes.
INDICATION FOR OPERATION: The patient is a (XX)-year-old, who has failed conservative management for posteromedial impingement syndrome. On examination, the patient does not have an incompetent ulnar collateral ligament. A recent MRI reveals a small posteromedial olecranon spur and an intact ulnar collateral ligament. The patient understands the risks and benefits of right elbow arthroscopy and wishes to proceed.
DESCRIPTION OF OPERATION: After the patient was identified in the preop holding area and a gram of Ancef was administered, the patient was then transferred back to the operating room and placed supine on the operating room table. After adequate general anesthesia was administered, the patient was then placed in a well-padded lateral decubitus position for right elbow arthroscopy.
Standard high posterior and posterolateral portals were then made. The posterolateral was a viewing portal and the posterior was the working portal. Both were made with small nicks in the skin followed by hemostat to bluntly dissect through the triceps tendon onto the posterior capsule into the olecranon fossa. Visualization with the elbow in full flexion, as well as full extension revealed an area of posteromedial impingement from a small osteophyte along the posteromedial edge of the olecranon tip and a shallow olecranon fossa.
A 4.0 full-radius resector and a 4.0 ball-tipped bur were used to remove the osteophytes from the olecranon tip, as well as enlarge the olecranon fossa. All soft tissue, which potentially could be sites of impingement in the posteromedial aspect of the elbow was removed. Upon burring and using a 4.0 full-radius resector, the guard was placed towards the ulnar nerve on the medial side at all times.
At this point, all instruments were removed, and staples were used for skin reapproximation. Marcaine 30 mL with epinephrine was then placed into the joint followed by a well-padded dressing. The patient was then awakened from general anesthesia and transferred to the recovery room in good condition. There were no complications.
