Arthrodesis of the elbow with two locking compression plates

Abstract

A technique of elbow arthrodesis is presented that uses the biomechanical advantages of recent advances in internal fixation technology. The main point is a dorsal locking plate with a medial stabilizing strut. Newer designed metaphyseal plates allow for fixation with 5-mm screws proximally and 3.5-mm screws distally. The use of locking screws and the orientation of 2 plates at 90 degrees to each other increase the strength and rigidity of the fixation. This is particularly important in the presence of small fusion surfaces, osteoporosis, and bone loss, which is often encountered in the patient with failed arthroplasty, infection, or severe trauma. The use of bone graft, substitutes, and bone morphogenic proteins can improve the chances of obtaining a successful fusion. Careful soft tissue handling and the use of hyperbaric oxygen are recommended to avoid wound complications prevalent in this patient group. Preoperative immobilization in a locked elbow brace at various degrees of flexion determines the most functional position of arthrodesis for the individual patient. We have only one case with the 2-plate technique, as described, that clinically and radiologically fused at 8 weeks. © 2007 Lippincott Williams & Wilkins, Inc.