Elbow Deformity is a very common skeletal deformity often as a result of trauma to the joint. Neglected or complicated fractures of the adjacent bones to the elbow joint may result in deformation, loss of joint motion and sometimes pain. Distal humeral fractures and radius head farctures and dislocations are the most common ones causing these complications. Once acuired they may cause limitaion of function both in daily living activities and sports. They may also cause loss of self esteem and aesthetic complaints. Depending on the very specific condition which creates the patient's complaints different surgical options may help to achieve both excellent aesthetic results and good functional results.
Elbow Deformity Due To Fracture Malunion
The cases of elbow deformity due to malunited fractures without harm to the joint cartilage and ligamentous complex can be treated with great aesthetic and functional results. Thanks to 3D computerised surgical planning and 3D printed patient specific surgical guides these tecnological advancements ensure safe and easy deformity corection surgery with predictable results.
The computerised surgical plan helps to determine the optimal osteotomy choice which will provide excellent deformity correction along with good bone contact for faster bone healing and ideal implant adaptation to obtain strong osteotomy fixation to enable early mobilisation exercises. The 3D printed patient specific guide is designed by bone surface mapping technique ensuring seamless match to patient's actual anatomy enabling safe and easy utlization. During the surgery the guide is temporarily mounted to the patient's bone where it naturally matches the anatomy and sits spontaneously. Later it is used as a ruler to perform the osteotomies assuring they are in line with the actual computerised surgical plan.
Elbow Deformity and Contracture Due To Trauma
Trauma around the elbow joint may cause severe disabilty If not properly treated acutely. These cases may often represent with concomitant fractures and dislocations at the same time. This sometimes causes the ligamentous injury to the joint to be overlooked. These cases of undertreated and severe-complicated elbow fracture/dislocations often represent with variable degrees of loss of joint motion (contracture), pain and feeling of insecurity. For these patients the most important parameter for predicting the surgical treatment results are state of cartilaginous anatomy of the joint and involvement of radius head pathologies. For cases with mild cartilaginous anatomy distortion and no radius head pathology generally good functional results can be obtained even for the patients with almost total loss of elbow joint motion. Depending on the level of contracture (loss of motion) and accompanying ligamentous pathologies the capsulalry release surgery to regain motion and function may be done by arthroscopic or open methods along with ligamnetous reconstructions if indicated.
Osteoarthrits of the Elbow Joint
Severe and communited fractures of the elbow may result in osteoathritis of the joint with marked distortion of the intrarticular joint anatomy and cartilage degeneration. Depending on the level of degeneration within the joint the patient may experience moderate to severe loss of joint motion as well as pain and various clicking and crackling noises with motion. These cases should only seek surgical treatment when such marked complanits are complicating even the simpler activities of daily living. Otherwise they should carry on with conservative treatment methods by refraining from heavy lifting/pushing and repetetive motion dependent tasks which are known to exarbate symptoms and advance the osteoarthritis. Yet, once they experience severe and prolonged limitaion of the daily living activities and light work these patients may benefit from surgical methods. Interposition arthroplasty is the treatment of choice form such patients except for the elderly ones. This surgical procedure addresses joint anatomy distortion and loss of cartilage by manula sculpting and debridement to obtain as much congruancy between the joint surfaces as possible and then resurfacing the joint with a tendon or fascial graft obtained either from the patient or from cadaver to obtain a cartilage like surface in between the joint to provide gliding through joint motion. This procedure along with ligament reconstruction may help improve pain, motion and function for carefully selected patients.