Elbow Arthrodesis as a Salvage Procedure for Combat-Related Upper Extremity Trauma.

Abstract

Upper extremity amputation is associated with significant disability. Elbow arthrodesis (EA) is a rarely indicated salvage procedure with a narrow set of indications. The purpose of this case series is to describe the clinical course of those patients undergoing an EA following severe combat-related, upper extremity trauma. 5 patients treated for combat-related upper extremity injuries treated with an EA between 2003 and 2012 were identified. Demographic information, injury characteristics, and treatment course were evaluated. 5 male patients with a mean age of 23.8 years were treated with an EA in relative extension following severe upper extremity trauma. 3 patients undergoing EA had concomitant bilateral above-knee amputations and 2 patients underwent fusion of their dominant arm. Successful arthrodesis was achieved in all patients. All patients reported good pain control without evidence of deep infection, the mean time from injury to arthrodesis was 305 days, and the mean time to arthrodesis was 714 days. The mean fusion angle among these patients was 138°. EA following severe combat-related, upper extremity trauma is a viable treatment option. In the multiply injured patient, arthrodesis in a position of extension may be advantageous to accommodate transfers and mobility.