PAKISTAN ARMED FORCES
MEDICAL JOURNAL (Category Y)

A Journal of Army Medical & Dental Corps

Being published since 1956

ISSN (online) 2411-8842
ISSN (print) 0030-9648

VOL 67, No. 6, DECEMBER 2017

ELBOW ARTHODESIS WITH AO EXTERNAL FIXATOR IN WAR INJURIES

Nisar Ahmed, Syed Tauqeer Ahmed Rizvi*, Muhammad Khalid Sadique*

Abstract

Objective: To analyze the surgical technique of Elbow arthodesis in term of its indications and functional outcome in war injured elbow joints.
Study Design: Descriptive study.
Place and Duration of Study: This study was carried out at Combined Military Hospital (CMH) Peshawar and CMH Quetta, from Apr 2007 to Sep 2013.
Material and Methods: Twenty patients all young males who had complex high velocity elbow joint injuries were selected for the study. Plan X-Rays were done for assessment and planning. Surgical technique for arthodesis involved use of AO external fixator 4mm alone in 15 cases and combination of external fixator with minimal internal fixation using K wires in 5 cases.
Results: Average duration of bony alkalosis and complete elbow arthodesis was achieved in 8 months (range 7 to almost 10 months). Almost 90% of the patients had pain free and stable elbow joint with satisfactory level of daily life activities and personal care hygiene.
Conclusion: Elbow joint is a commonly involved body part in the battle field resulting in extensive bone and soft tissue damage along with heavy contamination. In these extensive injuries no surgical reconstruction is possible, therefore, early wound debridement and elbow arthodesis at an appropriate angle with external fixation and vascularized soft tissue coverage whenever required is an effective method of treating such injuries.

Keywords : Blast injuries, Bone graft, Elbow arthodesis, External fixator, Non-union, Osteomylitis, Reconstruction of elbow.



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