Reconstructive surgeries and endoprosthetics of the elbow joint: indications, possibilities and prospects

Abstract

BACKGROUND: Severe injuries of the elbow joint and their consequences are a serious problem in modern traumatology and orthopedics due to the large number of unsatisfactory treatment results, in particular, due to the lack of a differentiated approach to the choice of tactics and the method of surgery. AIM: To evaluate the results of a differentiated approach to the choice of tactics and the method of surgical intervention in the treatment of patients with injuries and consequences of injuries of the elbow joint. MATERIALS AND METHODS: The results of treatment of 245 patients with injuries and consequences of damage to the elbow joint were assessed within 11 years from the date of surgery. Six groups of patients were identified: group 1 osteosynthesis of fractures of the elbow joint; 2nd open arthrolysis without the imposition of Oganesyans hinged distraction apparatus (HDA); 3rd open arthrolysis with the imposition of HDA; 4th arthroscopic arthrolysis without HDA imposition; 5th arthroscopic arthrolysis with the imposition of HDA; 6th elbow arthroplasty. RESULTS: In 93% of patients after osteosynthesis (1st group of patients), a good result was obtained (the deficit in the range of motion was not more than 10, the average score on the DASH scale was 8). In patients after arthrolysis, there is a twofold increase in the range of motion (on average from 4250 to 114120), and regardless of the method of arthrolysis (arthroscopic or open) and whether HDA was used or not. On the DASH scale, 89% of patients showed a decrease in points on average from 77 to 36. In the 6th group, an increase in the range of motion was noted on average from 4548 to 126135, on the DASH scale a decrease in points from 7982 to 3944 on average. Revision intervention was required in 28.4%. CONCLUSION: The choice of the method of surgical treatment of injuries and the consequences of severe injuries of the elbow joint directly depends on the degree and nature of destruction of the bone-articular and soft tissue structures, the deficit in the range of motion in the joint.