Total Elbow Replacement: Solution to a difficult problem

We hear about knee replacements and hip replacements every single day. Total elbow replacement is a word which sounds foreign to most ears. 

Here is a case illustration which will educate you about the possibilities of new surgical solutions.

Mr. XYZ a salesman and a right handed guy sustained an elbow fracture in 1984. His fracture was fixed locally in Rajasthan. Unfortunately his fracture did not unite and he carried on with his flail elbow. Tragedy stuck again and he fell down in March 2008. The plates and screws came of the bone. Another surgeon took the metal work out but this resulted in his major nerve getting damaged. He came to me in August first week with a flail (a straight elbow with no movements) elbow and a paralyzed wrist.
Obviously he could not do anything with this elbow. See his photographs before surgery.

The x-rays given below show that there is a tiny piece of his old fracture around the elbow. 
 
I decided to go ahead with a total elbow replacement surgery. Total elbow replacement surgery is popular in the western countries and usually is reserved for rheumatoid arthritis. In India it is rarely done for rheumatoid arthritis. Most of the use is for post traumatic conditions like this. There is an elbow available which is manufactured in India but has a very crude design and lacks various sizes. Elbow replacement surgeries have also been plagued by lot of complications. However the Conrad –Moorey elbow is one of the longest followed up elbow. I decided to use this implant (see how the implant looks).

 
He went home in 2 days time after surgery.
This is how his x-ray looked.
 
He currently has a good range of movements and is undergoing further rehabilitation.

The cost of the implant is around 1,00,000 i.e. expensive. The common complications are infection, nerve palsies and loosening. Mr. XYZ had no early complications and will keep following up to detect late complications.

for more details log on to www.drarchik.com