Abstract
Objective To report clinical results of reconstruction of the deficient coronoid to improve the elbow stability for the treatment of chronic elbow dislocation. Methods From July 2008 to January 2010, we preformed coronoid reconstruction with autogenous olecranon or radial head after arthrolysis for 6 patients with chronic elbow dislocation complicated with deficient coronoid. All the 6 patients were male, withan average age of 30.5 years (18 to 42 years) at the time of surgery. Four right and 2 left elbows were affected. The average time from injury to surgery was 5 months (2 to 11 months) . All the primary injuries were terrible triad. The average range of elbow motion before operation was 13.3° (0 to 35°), and the average range of forearm rotation before operation was 62.5° (10° to 140°) . Through a standard posterior skin inci sion, the elbow joint was dislocated posteriorly in extension after arthrolysis to reconstruct the coronoid with autogenous olecranon or radial head. After fixation with screws or k-wires, the Stryker hinged external fixator was used for protection. Exercise began the first day after operation, Indomethacin was administered to prevent ectopic ossification. The external fixator was removed after 8 weeks. Results The mean follow-up time was 12 months (3 to 21 months) . The average range of elbow motion after operation was 120.0° ( 100° to 140°), and the average range of forearm rotation after operation was 141.7° (110°to 170°) . The average Mayo elbow performance score increased from 51.7 (50 to 55) before operation to 97.5 (85 to 100) after operation. All the 6 elbows were stable in extension after coronoid reconstruction. Conclusion Since coronoid reconstruction with autogenous olecranon or radial head can substantially improve the elbow stability,it is a good treatment for chronic elbow dislocation complicated with deficient coronoid. Key words: Elbow joints; Dislocation; Wounds and injuries; Recovery of function
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