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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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
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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
What is the preferred treatment for a propionibacterium acnes infection that has been symptomatic for 6 months after total elbow arthroplasty with well-fixed components, good bone stock, and a healthy patient?
Non-operative treatment with IV antibiotics for 6 weeks
Arthroscopic irrigation and debridement
Open irrigation and debridement with poly exchange
Single stage revision arthroplasty
Two stage revision arthroplasty
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