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)
Fracture along length of humeral or ulnar stem.
II1: well-fixed implant
II2: loose implants, good bone stock
II3: loose implants, severe bone loss
II1: ORIF with component retention +/- strut allograft
II2: Revision arthroplasty using long-stem prosthesis ± strut allograft and impaction bone grafting. Locking plates/ cerclage wires may be added for added stability.
II3: Require revision arthroplasty with extensive allograft supplementation. Often times require resection arthroplasty
If implants are well-fixed, immobilization for humerus and ORIF for ulna.
If implants are loose, treat as Type II2 fractures.
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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
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