The aim of this abstract is to show that acute osteomyelitis is one of the most feared complication of orthopedic surgery. A rapid and aggressive treatment is mandatory in order to avoid significant bone loss, joint destruction and, in most cases, salvage of the limb. After apparent cure of the infection, sequelae must be addressed. In this case, the joint destruction was important, so reconstruction procedures where impossible. In a superficial and relatively small joint such as the elbow, it is preferred to do an arthrodesis than an arthroplasty because the risk of reactivation of the infection with implant involvement is very important. We present a case report of a 69 years old woman, who had a supra-intra-condylar fracture (AO 13-C1) of the right humerus. She was treated with open reduction and internal fixation with 2 internal lag screws and 2 external lag screws. After 6 weeks, she was admitted with a dislocated elbow associated with pain, loss of limb function, cubita nerve palsy and a purulent discharge from the surgical wound. She started vancomycin and was submitted to surgery with debriment, hardware removal and fixation with an external fixator was used. The local signs of infection disappeared progressively. After normalization of the laboratory parameters of infection, the patient was submitted to an elbow arthrodesis using a posterior contour plate. The elbow achieved solid fixation and infection was eradicated, at least for the time being, allowing the patient to use the upper limb in her daily live activities. The treatment of post operative acute osteomyilits is challenging, In this case, after apparent solution of the infection, a solid fixation of the elbow was achieved, allowing the use of the upper limb in the patient daily activities.
Olecranon Osteotomy is a common approach used in the management of intraarticular
Purpose of the study. To evaluate the outcome of the Modified French osteotomy for the correction of cubitus varus resulting from a supracondylar
We aimed to assess the functional outcomes of elderly patients with isolated comminuted
Adequate exposure is a prerequisite for treatment of distal humeral fractures. In this study, we compared the clinico-radiological and functional outcome of TRAP approach with that of olecranon osteotomy for
Background. Level 1 studies for fracture management of upper extremity fractures remains rare. The influence of these studies on management trends has yet to be evaluated. The purpose of this study was to examine alterations in national trends managing mid-shaft clavicle and intra-articular
The problem of retained drain fragments is a well known but under reported complication in the literature. The authors present the case of a 66 years old male, who suffered a right
Introduction:.
Background. The procedures of total elbow and shoulder replacements increased 6% to 13% annually from 1993 to 2007 with revision-related burden increasing from 4.5% to 7%. The revisions of the shoulder and elbow prostheses due to aseptic loosening, periprosthetic fractures, infections have led to the use of standard or custom-made implants due to significant bone loss. This study reports our experience in the management of complicated primary and revisions of total shoulder and elbow replacements with significant humeral bone loss and in metabolic diseases of the elbow and shoulder treated with bone resection using The Mosaic Humeral Replacement System. Patients and Materials. A total of 20 patients underwent total elbow or shoulder arthroplasty using the Mosaic Humeral Replacement System (Biomet, UK). The Mosaic system was used in 8 shoulder arthroplasties (Group A) and in 12 elbow arthroplasties (Group B). The underlying pathologis in Group A included 2 malunited proximal humerus fracture, 1 humeral osteomyelitis, 1 shoulder chondrosarcoma, 1 aggressive Gigantic Cell Tumor with prosthetic fracture, 2 metastatic lytic lesion, and 1 failed fixation of non-union proximal humerus. Figure 1 shows Mosaic implant after complex fracture of proximal humerus. Reasons for Mosaic arthroplasty in Group B included 3 humeral component revisions due to periprosthetic fracture, 1 prosthesis breaking-up with fractures, 1 revision of loose Souter Strathclyde prosthesis, 1 loose prosthesis due to infection, 1 highly comminuted elbow fracture, 1 aseptic loosening of humeral component of total elbow replacement, 3 revision of total elbow replacement due loosening and 1 pathological