Total Elbow Arthroplasty as a Salvage for the Fused Elbow

Published on 11/04/2015 by admin

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Last modified 11/04/2015

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CHAPTER 58 Total Elbow Arthroplasty as a Salvage for the Fused Elbow

INDICATIONS AND PATIENT SELECTION

The primary goal of total elbow arthroplasty is to restore motion to improvement function. We prefer a patient older than 60 years of age if the pathology follows trauma.8 However, pathologic and functional considerations may prompt replacement at an earlier age, especially in those with inflammatory conditions. Of note is that the extent of comorbidities that tends to exist in these patients further complicates the execution of the procedure.

Radioulnar, radiohumeral, or a combination of these synostoses, with complete loss of forearm rotation, may occur in more than 33% of patients (Fig. 58-2).11 The incidence of additional joint involvement in the ipsilateral and contralateral extremities was 77% and 46%, respectively, in our experience. In fact, in our experience, an isolated elbow fusion occurred in less than 10% of patients.

Post-traumatic neuropathies are also common and may occur in as many as 40% of patients. As a matter of fact, two patients in our published series had previous Volkmann’s ischemic contracture. These complications mitigate the age factor when considering this procedure.

EXPECTATIONS

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