Total Elbow Arthroplasty as Treatment of Non-union with Bone Loss of Distal Humerus – A Case Report

INTRODUCTION: Total elbow arthroplasty (TEA) is a viable treatment for pain-free mobility in stiff elbow of sedentary patients with rheumatoid arthritis and ankylosis. Secondarily, TEA is useful in cases of stiff failed fixation and bone loss of distal humerus fractures. CASE REPORT: A Fifty one years old sedentary male presented to our institute with a history of injury to the right elbow (sideswipe injury). On clinical and radiological examination, it was open Grade III B fracture of distal humerus with bone loss. He was treated with wound debridement and initial temporary fixation with k-wires and later soft-tissue reconstruction. One year later, the patient upper limb was flail, limited range of motion (passive 40° 70°) and no infection. Radiology revealed non-union of condylar fragments with bone loss of distal humerus. The patient underwent TEA through standard triceps reflecting approach. He was implanted cemented modular Coonrad-Murray semi-constrained prosthesis Type III. The post-operative period was uneventful. At 4-year follow-up, the patient is pain free with elbow range of motion 5°120°. CONCLUSION: In failed osteosynthesis and sedentary patients, TEA is a SALVAGE surgery for pain-free mobility with its own long-term limitations.