[Elbow arthrodesis and its alternative]

Significant functional impairment, increasing pain or joint infection are the indications for arthrodesis of the elbow joint. Six patients underwent a compression arthrodesis with internal and external fixation and an additional bone graft in our institution between 1987 and 1993. Out of this series only one patient developed a non-union due to a fall on the extremity. In a series of nine patients treated with external fixation alone between 1978 and 1987, four patients developed a non-union. Unlike other joints, there is no optimal position for arthrodesis of the elbow and the functional deficit cannot be compensated by the other joints of the upper extremity. Therefore, it should be useful to know if an interposition arthroplasty is possible. With this technique a joint infection can be healed. Ten patients treated with this technique between 1987 and 1993 had no recurrent infection. Two patients had instability. The best results were achieved in post-traumatic joint stiffness. Permanent instability and post-traumatic arthritis are indications for an allo-arthroplasty. Contraindications are a previous joint infection and intensive bone loss, as well as ipsilateral shoulder ankylosis and neuropathic joint disorders. In younger patients, resection arthroplasty is better due to a high loosening rate of the prostheses.