A non-surgical approach by Mr Ali Noorani sees dentist, Dr Kotecha back to work in three weeks after torn ligaments and complete dislocation of his elbow

In late 2015 Dr Kotecha suffered a nasty fall while playing 5-a-side football. It resulted in the complete dislocation of his right elbow and all of his elbow ligaments were torn. Fortunately, it was a ‘simple’ dislocation, meaning it had no bony injuries, as opposed to a complex dislocation which has a fracture associated with it and usually requires fixation.

Dr Kotecha was admitted to hospital, where he was given an anaesthetic so his elbow could be put back in place. Afterwards, he was given an elbow brace. Unfortunately, he developed a severe reaction to the latex in the brace, and so was transferred to a different hospital to be treated for cellulitis.

Dr Kotecha was advised that he would need surgery to repair the ligaments in his elbow. He was anxious about this prospect, particularly given the anticipated six months off work, and so decided to seek a second opinion. He met with Mr Noorani because of his expertise in complex elbow trauma. Mr Noorani examined Dr Kotecha’s injury and confirmed the diagnosis with a CT scan. Together, they discussed Dr Kotecha’s hopes and needs in order to create a personalised treatment plan. Mr Noorani explained how, given the injury was a simple dislocation, Dr Kotecha would benefit from a non-surgical accelerated rehab programme. Ultimately, this gave him normal function and a stable elbow and he was able return to work within just three weeks.

Mr Noorani said “A decision not to operate is sometimes even more important than one to fix it. This case highlights the role of a definitive opinion and accurate decision making process to get the correct management for a particular clinical problem.”

Dr Kotecha said “I am indebted to Mr Noorani for his care and advice which minimised the mental and physical trauma of such a serious injury.”