Jornal de Trauma e Tratamento

Radiohumeral Arthrodesis for Severe Open Communited Fracture Using External Fixation: A Case Report

Abstract

Naoki Kato, Tetsuya Torio, Hiromi ODA and Hiroya Sakai

Recently, prosthetic replacement has been commonly applied as a standard procedure for the elbow joint destruction by arthritis or trauma, and elbow arthrodesis has been used only for patients who are unsuitable for other conventional treatment methods. In most cases, ulnohumeral arthrodesis is performed, considering the geometry and the amount of surface area of the distal humerus and proximal ulna. In this report, we present a successful case of the radiohumeral arthrodesis using unilateral external fixation without bone grafting for a patient who sustained severe open communited fracture with transarticular massive bone loss. We decided to fuse the elbow at 70 degrees of flexion, and the forearm was fixed at 80 degrees of pronation. At 13-month after the operation, radiographic evidence of solid enlarged right elbow fusion was gained. At more than three years after operation, we evaluated patient-oriented quantitative functional disability using Disabilities of the Arm, Shoulder and Hand (DASH) to confirm that radiohumeral arthrodesis fixed at this angle could be accepted. This technique can be recommended as a salvage procedure in the face of significant bone loss of the proximal ulna.