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Total Elbow Arthroplasty with Condylar Preservation for Post-Traumatic Non-union with secondary Arthropathy: A Case
Deepanjan Das1, Ankush Mohabey1, Priyanshu1
1Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, MIHAN, Nagpur, Maharashtra, India.
Introduction:
Total elbow arthroplasty (TEA) is a valuable salvage procedure, traditionally reserved for elderly or rheumatoid patients. However, expanding indications have allowed selective application in younger patients with debilitating post-traumatic elbow pathology.
Case Report:
A 74-year-old female presented with persistent instability and ulnar neuropathy following non-union of a distal humerus fracture and chronically dislocated elbow, complicated by progressive arthropathy. On evaluation, she exhibited valgus-varus laxity, restricted range of motion (ROM), and crepitus. A semi-constrained TEA was performed using a posterior triceps-splitting approach. The humeral condyles, though destabilised from prior instrumentation, were preserved and secured using No. 5 Ethibond sutures. These sutures were tied to the humeral prosthesis. Postoperatively, by 3 months the patient achieved a functional, pain-free elbow with improved ROM and resolution of neurological symptoms.
Conclusion:
This case highlights the potential of condylar-preserving TEA as a reliable management option with advanced post-traumatic elbow dysfunction. Even in the presence of instability, non-union and prior instrumentation, preserving the native condyles and securing them to the prosthesis can yield a stable, pain-free, functional result.
