Macomb Teen Back on the Ice After Complex Elbow Surgery

Playing AAA hockey is a big part of Carson’s life. He is only 14 years old but already some colleges are reaching out to kids his age about potentially playing hockey.

In January of 2017, Carson was hit while playing hockey and he heard a pop around his elbow according to his mother Elizabeth.

“We weren’t sure the extent of his injury but he was definitely in pain,” Elizabeth says.
Carson went to a local hospital where x-rays and an MRI were performed. Elizabeth recalls that the doctor said the bone was not broken but he should undergo physical therapy and give it time to heal.

After physical therapy and a one year checkup, x-rays revealed that Carson’s bone was broken at the bony tip of the elbow. Unfortunately local orthopedic physicians did not offer surgical or other treatment options for Carson.

“Carson continued to be in pain. He also grew 6 inches during this time. In addition to the pain, he had limited movement in his right arm and could not bend it up to his shoulder. I have a teenager who loves to play hockey and this injury was affecting his quality of life. He had a hard time doing basic things like opening the car door and refrigerator,” says Elizabeth.

Not satisfied with the answers from local doctors that nothing could be done or that surgery could make his condition worse, Elizabeth took the advice of another mom who is a physical therapist and suggested that Carson be evaluated by Kunal Kalra, M.D., orthopedic surgeon at DMC Children’s Hospital of Michigan, who specializes in sports medicine.

Dr. Kalra suggested that another MRI be performed to help evaluate if surgery could provide an option and ultimately eliminate Carson’s elbow pain. He says when he initially saw Carson his fracture had still not healed and was causing him significant pain on a daily basis.

“He couldn’t enjoy the things he liked doing such as playing hockey. The part of his bone that was broken (radial head) performs a critical function in the elbow joint and is responsible for not only stability of the joint but also smooth rotational movements such as opening a door or turning a screwdriver. His elbow had already started to show some cartilage damage,” says Dr. Kalra.
Elizabeth says because the potential surgery was very complex and had many potential risks including the fact that Carson’s pain could get worse the family thought deeply about the decision to proceed with surgery but Dr. Kalra eased their fears.

“Dr. Kalra was so thorough in his explanation of the surgery. He consulted with many outside experts and answered all of our questions in great detail. He made us feel very confident that Carson was in the right place for this treatment,” says Elizabeth.

The family was greatly relieved as soon as the surgery took place. Dr. Kalra informed the family that he felt the surgery was a success and Carson could be back to normal and be able to play hockey in four to six months.

“We were astounded that only six weeks after surgery Carson was already 80 percent healed and after 3 months he was able to play hockey,” says Elizabeth.
Carson worked hard to recuperate with physical therapy and the use of a bone stimulator. His mom is happy to report that he is pain free and has full range in his elbow.

Dr. Kalra explains that the surgery involved working around a critical nerve and fixing the fracture at the right location.

“I had to remove all the previous scar tissue and the tissue that had not healed to get to the fracture site. I had to carefully elevate the depressed fragment and make sure the cartilage surface is well aligned. The surgery was successful but much of the credit for the early recovery goes to

Carson and his very supportive parents who always had the right attitude. I didn’t want to take any chances with his bone healing, especially with the high stakes involved because of his age, the critical location and his high athletic demands and so I also recommended a bone stimulator, a device that uses ultrasound to stimulate healing, which is sometimes recommended in non-unions (bone that has not healed in a long time),” says Dr. Kalra.

For others that may have a complicated injury such as the elbow injury that Carson had, Elizabeth suggests to keep searching for options if you don’t feel comfortable with the recommendations.

“As a mom, I’ve learned to trust my gut instinct. I was not satisfied that Carson could potentially be in pain for the rest of his life. Dr. Kalra was very honest with us and told us surgery could be a risk but he was very thorough in his assessment and we are thrilled with the outcome,” she says.

For further information visit Orthopedics at the Children’s Hospital of Michigan or request an appointment.