Radiohumeral arthrodesis with external fixation. A minimally invasive procedure for failed revision joint replacement of the elbow

Sala Francesco, Bonifacini Carlo, Martinelli Nicolò, Rosario Spagnolo, Capitani Dario

Abstract


Elbow arthrodesis (EA) is a rare procedure to be performed and it is still considered a salvage approach to be chosen in selective cases only5,9,10 . As reported by Koller it is one of the most difficult arthrodesis to perform for the surgeon with a high impact on the patients’ quality of life7 . This procedure is even more challenging when a massive bony defect occurs as it is the case after removal of a failed total elbow arthroplasty4 . Traditional EA is performed between the humerus and the ulna, due to the larger surface areas available, as reported by Staples, who described the employment of an olecranon wedge against the humerus15, or by Müller and Song, who suggested a plate compression between those two bones7,14 . The hypothesis whether an radiohumeral arthrodesis may be performed when the proximal ulna is completely absent due to reabsorption is based on anectodal evidence and few alternatives, as vascularized bone grafting, or renewed arthroplasty are available to the surgeon6,9 . We present a case report of a 75 year old woman who had a history of multiple total elbow replacement failures with a massive ulnar bone loss in which a radiohumeral arthrodesis with external fixation was performed. Complete fusion was obtained with more than satisfactory results on the patient’s quality of life.

Keywords


Elbow arthroplasty; radiohumeral arthrodesis; external fixation; minimally invasive procedure; arthroplasty failure; physical function

Full Text:

HTML PDF CITATION

References


Arafiles RP. A new technique of fusion for tuberculous arthritis of the elbow. J Bone Joint Surg Am. 1981 Dec;63(9):1396-1400.

Bilic R, Kolundzic R, Bicanic G, Korzinek K. Elbow arthrodesis after war injuries. Mil Med. 2005 Feb;170(2):164-166.

Davies R, Holt N, Nayagam S. The care of pin sites with external fixation. J Bone Joint Surg Br 2005;87:716-719. doi :1302/0301-620X.87B5.15623.

Ferlic DC, Clayton ML. Salvage of failed total elbow arthroplasty. J Shoulder Elbow Surg 1995;4:290-297.

Kalicke T, Weber O, Backhaus M, Muhr G, Citak M. Salvage procedures of the elbow. Alternatives to elbow arthroplasty. Unfallchirurg 2010;113:990-995. doi: 10.1007/s00113-010-1901-x.

Kato N, Torio T, Hiromi ODA, Sakai H. Radiohumeral arthrodesis for severe open communited fracture using external fixation: a case report. J Trauma Treatment 2012;1:105. doi:10.4172/jtm.1000105.

Koller H, Kolb K, Assuncao A, Kolb W, Holz U. The fate of elbow arthrodesis: indications, techniques, and outcome in fourteen patients. J Shoulder Elbow Surg 2008;17:293-306. doi:10.1016/j.jse.2007.06.008.

Müller ME, Allgöwer M, Willenegger H. Technique of internal fixation of fractures. Berlin: Springer; 1965. p. 47-51. (ISBN: 978-3-642-88358-3).

Presnal BP, Chillag KJ. Radiohumeral arthrodesis for salvage of failed total elbow arthroplasty. J Arthroplasty 1995;10:699-701.

Rashkoff E, Burkhalter WE. Arthrodesis of the salvage elbow. Orthopedics. 1986 May;9(5):733-738.

Reichel LM, Wiater BP, Friedrich J, Hanel DP. Arthrodesis of the elbow. Hand Clin. 2011 May;27(2):179-186, vi. doi: 10.1016/j.hcl.2011.02.002.

Sakkers R, Lammens J, Reynaert P, Fabry G. Ilizarov reconstruction after a failed upper limb salvage procedure in oncology: a case report. J Shoulder Elbow Surg. 2000 Mar-Apr;9(2):148-151.

Smith MV, Calfee RP, Baumgarten KM, Brophy RH, Wright RW. Upper extremity-specific measures of disability and outcomes in orthopaedic surgery. J Bone Joint Surg Am. 2012 Feb 1;94(3):277-285. doi: 10.2106/JBJS.J.01744.

Morrey BF, An KN, Chao EYS. Functional evaluation of the elbow. In The elbow and its disorders, edited by B. F. Morrey. Ed. 2, pp. 86-89. Philadelphia, W. B. Saunders, 1993.

Song DJ, Wohlrab KP, Ingari JV. Anterior ulnohumeral compression plate arthrodesis for revision complex elbow injury: a case report. J Hand Surg Am 2007;32:1583-1586. doi:10.1016/j.jhsa.2007.07.017.

Staples OS. Arthrodesis of the elbow joint. J Bone Joint Surg Am 1952;34:207-210.

Tang C, Roidis N, Itamura J, Vaishnau S, Shean C, Stevanovic M. The effect of simulated elbow arthrodesis on the ability to perform activities of daily living. J Hand Surg 2001;26A:1146-1150.

Kollig E, Esenwein SA, Muhr G, Kutscha-Lissberg F. Fusion of the septic ankle: experience with 15 cases using hybrid external fixation. J Trauma. 2003;55(4):685-691.

Wiedel JD. Salvage of infected total knee fusion: the last option. Clin Orthop 2002;404:139-142.

Green SA. Skeletal defects.Acomparison of bone grafting and bone transport for segmental skeletal defects. Clin Orthop Relat Res 1994;301:111-117.




DOI: http://dx.doi.org/10.15383/jmio.3

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

e-ISSN 2409-5141
 
Asia Press
 
Asia Press is a professional Science, Technology and Medicine publisher, who owns rapid publication, Peer-Reviewed, Open Access Journals. Asia Press aims to promote “knowledge sharing”. As you know, the main barrier for free “knowledge sharing” is the cost of publishing and transfer. In order to encourage scholars and scientists to the max, and devote whole power to realize the aim of “knowledge sharing” and the benefit of “all” mankind, Asia Press performs a permanent policy of no charge for publication and access, and always open its door for authors worldwide.
© 2013-2017 by the Asia Press. All rights reserved.