Interposition Arthroplasty of the Elbow with Hinged External Fixator for Post-Traumatic Arthritis

Author(s): Nolla J, Ring D, and Jupiter J

Source: Journal of Shoulder and Elbow 17:3: 459-64, 2008.

Summary:

This is a retrospective series of 13 patients who underwent interposition arthroplasty and temporary hinged external fixation for severe post-traumatic elbow arthrosis.    The authors reviewed their experience at a mean of 4 years following the procedure.

Clinically, the authors note that the mean arc of flexion improved from 48 degrees to 110 degrees.  The mean post-operative Moberg-Morrey score was 77 points, with a mean improvement of 41 points.  The results showed 1 excellent, 4 good, 4 fair and 4 poor results.

The significance of this study is that the authors clearly document that the worst results with these procedures were seen in patients with severe instability associated with bone loss of the distal humerus or trochlear notch.  This remains a salvage procedure for severe arthrosis in younger individuals or in the setting of a prior infection.  While motion may improve, instability often persists even in successful cases.