ELBOW ARTHODESIS WITH AO EXTERNAL FIXATOR IN WAR INJURIES

Elbow Arthodesis in War Injuries

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.

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