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Case Reports
. 2016 Sep-Oct;6(4):49-52.
doi: 10.13107/jocr.2250-0685.566.

Treatment of Stiff Elbow in Young Patients with Interpositional Arthroplasty for Mobility: Case Series

R Sivakumar  1 , V SomaSheker  1 , Prahalad Kumar Shingi  1 , T Vinoth  1 , M Chidambaram  1
Affiliations
Case Reports

Treatment of Stiff Elbow in Young Patients with Interpositional Arthroplasty for Mobility: Case Series

R Sivakumar et al. J Orthop Case Rep. 2016 Sep-Oct.

Abstract

Introduction: The elbow is a complex joint involving many articulations and complex biomechanics come into play. Elbow motion is crucial to upper limb movement that loss of 50% of elbow function equals to loss of 80% of upper extremity global function. Restoring movement and stability is challenging to the surgeon while treating a stiff elbow. Unlike other arthroplasties of hip and knee, total elbow arthroplasty (TEA) may not be a primary treatment. Interpositional arthroplasty (IPA) can be considered a viable option in posttraumatic arthritis of elbow in young patients.

Case report: We report two cases of interpositional arthroplasties done in young patients secondary to posttraumatic event. The first case is 22-year-old female with a history of stiff elbow following a posttraumatic event 3 years back and the second case is 24-year-old male laborer with stiff elbow following trauma more the 10 years back for which he took native treatment. In both the cases through posterior approach to the elbow, we did osteolysis and prepared fascia lata grafts are interpositioned over the recreated articular surfaces. Both the patients in the follow-up have a good range of motion, stability and are satisfied.

Conclusion: IPA is a good treatment option in young patients with posttraumatic arthritis. Elbow instability, fascia rupture, thigh pain, and hernia are the problems of IPA. IPA to TEA transition is possible.

Keywords: Posttraumatic arthritis; elbow mobility; fascial resurfacing arthroplasty; interpositional arthroplasty.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Case 1 patient elbow fixed at 90°.
Figure 2
Figure 2
Surgical position and draping (Case 1).
Figure 3
Figure 3
Exposure and preparation of joint surfaces (Case 1).
Figure 4
Figure 4
Tensor fascia lata graft (10 cm × 6 cm) folded onto itself and prepared (Case 1).
Figure 5
Figure 5
Graft fixation onto distal humerus articular surface (Case 1).
Figure 6
Figure 6
Pre and post-operative elbow radiograph (Case 1).
Figure 7
Figure 7
Post-operative clinical follow-up – extension (Case 1).
Figure 8
Figure 8
Post-operative clinical follow-up – flexion (Case 1).
Figure 9
Figure 9
Pre and post-operative X-ray radiography (Case 2).
Figure 10
Figure 10
Post-operative clinical picture (Case 2).
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