February 28, 2023
"I Should Have Gone Goldfarb Sooner"
By Thomas Melton
Thomas Melton broke his right elbow after he tripped and fell while running. He had multiple treatments with local doctors in Birmingham, AL. Those treatments failed resulting in intense pain. He was looking for answers, which he found with Charles Goldfarb, MD, a Birmingham native himself. Thomas was thrilled to learn of the research and peer reviews Dr. Goldfarb had done regarding his case prior to scheduling surgery. The surgery was a success and Dr. Goldfarb arranged for Thomas to have follow-up appointments with a trusted surgeon in Birmingham. Following a recovery process, Thomas has returned to a higher quality of life and excellent function of his right arm. "My trip to St. Louis to see Dr. Goldfarb at Washington University Orthopedics is certainly one of the best decisions of my life," Thomas shared. "I should have gone Goldfarb sooner."
Read the full story, in Thomas' words, below.
First and Second Attempt
"As a result of a trip and fall while running in April of 2019, I suffered a comminuted displaced fracture of my radial head (right elbow). After treating with multiple orthopedic specialists in my hometown, I underwent surgery in Birmingham, Alabama in June of 2019 whereby a titanium implant was placed in my elbow joint. While providing some initial stability, the titanium implant quickly started to irritate surrounding nerves and muscles which resulted in increasing pain and limited range of motion. Due to these worsening problems, I underwent another operation in October of 2020 whereby the titanium implant was removed. Following this removal, the unsupported bone around the original fracture site began grinding and popping which once again irritated the surrounding nerves, tendons and ligaments.
Affecting Every Aspect of Life
Given that my original injury and resulting surgeries were to my dominant arm, my pain and limited range of motion affected every aspect of my life. Prolonged writing and even typing, essential functions in my daily practice of law, became extremely painful. Simple activities of daily living became chores due to increasing pain with limited range of motion and function. I had difficulties shaving, showering and dressing in the morning; working throughout the day; and, simply sleeping through the night as the stiffness required repeated needs for repositioning of my arm.
The only solution offered locally was a third surgery to implant yet another titanium radial head at the elbow joint. This surgery would have required an even longer screw than the first due to the existing bone already being bored from the original implant. As this solution had previously been tried without success, I decided to seek a second opinion from Charles Goldfarb, MD. I contacted Dr. Goldfarb as I was aware of his reputation from my relationships with members of his family here in Birmingham.
Seeking Treatment in St. Louis
At my first appointment, Dr. Goldfarb had already researched my injury, my history and potential solutions. At our initial meeting, Dr. Goldfarb was able to suggest a procedure whereby a nonessential muscle in the arm could be moved and attached to the bones in problem area. Dr. Goldfarb explained that this approach may provide stability in the area of bone loss without using hardware. In addition, Dr. Goldfarb advised that he would take a tendon allograft and place it between my radius and ulna thereby providing a natural cushion between the two bones given the absence of a radial head. This procedure was previously unknown to me both through my own inquiries and through my multiple prior orthopedic consults. Not only did Dr. Goldfarb research this solution prior to my first appointment, he also peer reviewed the suggested procedure with another specialist across the country following this appointment and before scheduling surgery.
Surgery with Dr. Goldfarb was a Success
Dr. Goldfarb performed the surgery as described on April 6, 2022. Knowing that I had traveled from Birmingham to St. Louis for surgery, Dr. Goldfarb graciously contacted a trusted colleague of his in my hometown to set up my post operative follow up visits and physical therapy. My range of motion quickly progressed over the first few weeks following surgery. With continued therapy, I was also able to quickly regain strength and rotation in my right arm. In a period of mere months, I went from three (3) years of consistent pain with activities and sometimes at rest, to rarely even thinking about my prior injury most days even with strenuous activities.
Higher Quality of Life
I have returned to using my right arm as my dominant arm to pick up items, to open doors and to reach for handshakes without hesitation or grimace. I am back to lifting weights with my right arm and have even been on bike rides. My quality of life has exponentially improved as a result of Dr. Goldfarb! I am so grateful for the medical knowledge, the time in research and the surgical skills of Dr. Goldfarb. This is especially true with my surgery as it also involved cleaning up arthritis at the fracture site and removing extensive scar tissue, all while cautiously protecting the radial nerve.
I cannot imagine where I would be today had I not been so fortunate to have become a patient. My trip to St. Louis to see Dr. Goldfarb at Washington University Orthopedics is certainly one of the best decisions of my life. Many thanks to Dr. Goldfarb, the nursing staff and Washington University Orthopedics!"
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