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Review Question - QID 7882

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QID 7882 (Type "7882" in App Search)
A 78-year-old woman undergoes an uneventful semiconstrained total elbow arthroplasty through a Bryan-Morrey approach. Her immediate postoperative management should include which of the following?

Five days of intravenous antibiotics for perioperative prophylaxis

0%

5/1212

Use of continuous passive motion beginning on postoperative day one

7%

82/1212

Immediate initiation of active flexion and gravity-assisted passive extension

21%

252/1212

Splinting at 60 to 90 degrees of flexion for 5 to 10 days, followed by initiation of active flexion and gravity-assisted passive extension

58%

703/1212

Splinting at 60 to 90 degrees of flexion until the triceps has healed, followed by initiation of active flexion and extension

11%

130/1212

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Postoperative management of total elbow arthroplasty patients is directed to avoidance of complications commonly associated with this procedure. Following total elbow arthroplasty, 24 hours of perioperative antibiotics should be given, consistent with other arthroplasty procedures. Because of the relatively thin soft-tissue envelope surrounding the elbow, particularly in patients with rheumatoid arthritis, consideration must be given to the surrounding soft tissues postoperatively. The surgical wound should be given several days of quiescence prior to initiation of motion to minimize wound healing complications. Splinting at 60 to 90 degrees allows tension to be removed from the soft tissues. Immediate motion places these tissues under immediate stress; immobilization of the elbow for 6 to 8 weeks until the triceps has healed would result in significant stiffness. Splinting should not be used more than 10 days to avoid stiffness of the elbow.

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