Total elbow replacement

Case contributed by Azri Johari
Diagnosis certain

Presentation

History of a mechanical fall resulting in a grossly displaced and comminuted supracondylar fracture of the right distal humerus.

Patient Data

Age: 75 years
Gender: Female

Pre-operative

x-ray

AP and oblique views show grossly comminuted distal humerus fracture present with marked displacement of the medial condyle.

Post-operative

x-ray

AP and lateral plain films post total elbow replacement.

Humeral and ulnar prosthetic components well aligned, medial epicondyle fracture fragment alignment satisfactory.

Radial head osteotomy noted.

Case Discussion

Total elbow replacements are becoming increasingly utilized in preserving elbow range of motion. Indications include complex comminuted distal humeral fractures, which cannot be reconstructed in the elderly (age > 70 years), late stage rheumatoid arthritis, and late stage osteoarthritis.

There are typically lifelong limitations to lifting weights no greater than two kilograms (five pounds).

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