1,016 research outputs found
Primary Total Elbow Arthroplasty in the Treatment of Complex Elbow Fracture: A Case Report
Introduction: Some elbow fractures are very complex with
inadequate bone stock, so it is not possible to perform a stable
fixation. However, loss of basic elbow function can severely affect
daily living activities. There are few alternatives to internal fixation,
but arthroplasty can be a reasonable option. The aim of this case
report is to evaluate the role of primary total elbow arthroplasty in
the treatment of complex elbow fractures.
Case study: A 54-year-old male patient presented at our emergency
department in the sequence of a motorcycle accident, which caused
an open fracture of the left elbow, classified as type IIIB of Gustilo
and Anderson. The X-ray showed comminuted fractures of distal
humerus and proximal ulna with bone loss from both epiphysis.
He started antibiotherapy and was submitted to immediate surgical
debridement, provisional fixation with an external fixator and skin
closure. The external fixator was removed 2 months after, when
the patient presented with great elbow instability. The X-ray and
the Computed Tomography showed signals of malunion and bone
loss, which prevented any kind of fixation. Therefore, 3 months
after, the patient was submitted to elbow joint replacement. A
posterior approach was used, in which the triceps was reflected
and was applied a linked arthroplasty - Coonrad-Morrey total elbow
arthroplasty. On the second week after surgery, passive motion
was started and by the fourth week, progressed to active motion.
Six months after, he presented without significant pain and with a
range of motion of 0° to 135º.
Conclusions: Although rarely used, total elbow arthroplasty may
be the choice in selected patients with elbow fractures with loss of
bone. As shown in this case, this treatment can lead to a satisfactory
functional recovery. Despite having some complications, more
recent studies encourage its use in the future
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