Undisplaced - Immobilization /soft tissue repair is sufficient to achieve fibrous union (Rigid fixation not required).
Displaced - ORIF with heavy nonabsorbable sutures or tension band wiring (if limited periprosthetic bone)
Revision arthroplasty using long-stem prosthesis ± strut allograft and impaction bone grafting. Locking plates / cerclage wires may be added for added stability.
May be performed in stages: Stage I - address fracture union with onlay iliac crest bone graft and LCDCP. Stage II (after fracture union) - revise implants with longer stem and impaction graft
If implants are well-fixed, immobilization for humerus and ORIF for ulna.
If implants are loose, treat as for Type II fractures.
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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
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Which patient would expect to have the longest implant survivorship after undergoing total elbow arthroplasty (TEA)?
Rheumatoid arthritis with unconstrained TEA
Rheumatoid arthritis with semiconstrained TEA
Primary osteoarthritis with semiconstrained TEA
Primary osteoarthritis with unconstrained TEA
Acute distal humeral bicolumnar fracture with semiconstrained TEA
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A 72-year-old woman presents for follow-up after elbow surgery. Her radiographs are shown in Figures A and B. Which of the following pre-operative diagnoses is a relative contraindication to the use of this prosthesis design?
Acute intra-articular distal humerus fracture
Malunited intra-articular distal humerus fracture
Late-stage rheumatoid arthritis
Post-traumatic bony ankylosis
A 62-year-old female with history of rheumatoid arthritis presents with end-stage elbow arthritis. Regarding total elbow arthroplasty (TEA) for rheumatoid arthritis, which of the following implant survival results would be expected?
Poor survival results by 5 years
Good survival results at 5 years, poor results by 10 years
Good survival results at 10 years, poor results by 15 years
Good survival results at 15 years
Lack of long-term survival studies regarding TEA for rheumatoid arthritis
A 78-year-old woman falls onto her nondominant left elbow and sustains the injury shown in Figure A. What treatment option allows her the shortest recovery time and highest likelihood of good function and range of motion?
Total elbow arthroplasty
Open reduction and internal fixation
Radial head arthroplasty
Sling and swathe