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Osteochondral reconstruction for post-traumatic coronoid deficiency.

Erica Kholinne1,2, Jae-Man Kwak2, Hyojune Kim2

  • 1Department of Orthopedic Surgery, St. Carolus Hospital, Faculty of Medicine, 482858Trisakti University, Jakarta, Indonesia.

Journal of Orthopaedic Surgery (Hong Kong)
|November 5, 2020
PubMed
Summary
This summary is machine-generated.

Osteochondral bone grafts can reconstruct the coronoid in post-traumatic deficiency, improving pain and motion. Graft height is crucial for survival, but secondary osteoarthritis is a risk.

Keywords:
coronoid deficiencycoronoid reconstructionosteochondral reconstructionpost-traumaticterrible triad

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Elbow Reconstruction

Background:

  • Post-traumatic coronoid deficiency presents a significant challenge in elbow reconstruction.
  • Osteochondral bone grafting is explored as a reconstructive method for this condition.

Purpose of the Study:

  • To evaluate the clinical outcomes and graft survival after coronoid reconstruction using osteochondral bone grafts for post-traumatic coronoid deficiency.
  • To assess the efficacy of this surgical technique in restoring elbow function and integrity.

Main Methods:

  • Retrospective review of eight patients with post-traumatic coronoid deficiency treated with osteochondral bone grafts.
  • Grafts sourced from radial head, olecranon tip, or iliac crest.
  • Clinical outcomes assessed via VAS, motion arc, and MEPS; radiological evaluation included CT and radiography.

Main Results:

  • Significant improvements observed in VAS pain scores (4.1 to 1.1) and MEPS (34.2 to 85.0) (p=0.018).
  • Elbow motion arc significantly increased from 84.2° to 102.1° (p=0.048).
  • All grafts survived, though two patients (25%) experienced nonunion; 37.5% developed secondary osteoarthritis.

Conclusions:

  • Coronoid reconstruction with osteochondral grafts offers a viable salvage option for post-traumatic coronoid deficiency.
  • Adequate graft height is essential for successful graft survival.
  • The risk of secondary osteoarthritis in the ulnohumeral joint requires careful monitoring.