Date: Sat, 18 Aug 2001 19:25:07 -0400
Subject: Elbow segmental bone loss
Dear list members,
I would like to present this case:
45 year old man. 4 years before, he was hit with a bar on his left forearm. The initial diagnosis was open fracture, grade I(Gustillo) of radius and ulna. He was hospitalized with a cenit traction for 2 months and after an external fixator was put on.
In August 1997 the Ex fix was removed and 2 DCP were put on and taken out 2 months later due to the infection with a large ostectomy of both forearms bones. Later in February 1998 a distal ostectomy of the humerus was performed.
His present physical examination:
Even though I prefer an above-elbow amputation for this particular case, I'm planning to perform two stage procedure. First, I will try to get maximum lengthening with a Ilizarov fixator and then in the second stage, do an arthrodesis of the fragments to 30 degrees of flexion.
Manuel Sotelo MD
Date: Sun, 19 Aug 2001 11:47:48 +0600
From: Alexander Chelnokov
DMS> maximum lengthening with a Ilizarov fixator and then in the second stage, doing a arthrodesis of the fragments to 30 of flexion.
I remember a similar case (but with the bone defect localized more proximally, with rather long forearm bones and very short proximal humerus) presented by colleagues from a military medical academy, StPetersburg, Russia. They performed lengthening of the humerus and then implanted a standard Sivash's elbow prosthesis, with stem placed through regenerate zone. As i realize, the implant was very old fashioned and there must be available much more convenient modern models of special design.
Alexander N. Chelnokov
Ural Scientific Institute of Traumatology and Orthopaedics
str.Bankovsky, 7. Ekaterinburg 620014 Russia
Date: Sun, 19 Aug 2001 07:14:12 -0400
From: Dr. Manuel Sotelo
Do you know is there exists double articulated Ilizarovs? (one for the humerus and one for the radius)?