PMC5937584_01
Peroperative situation. Posterior arthrotomy (a); marking and preservation of the ulnar nerve (yellow loop) (b); debridement of the ulnohumeral joint (c, d); good cartilage quality on the radial head (d); debrided ulnohumeral joint (e); interposition arthroplasty with sutured fascia lata graft, like a waterfall (f).
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fig1
The patient underwent Grika interposition arthroplasty (see surgical technique paragraph and Figure 1) followed by a suitable rehabilitation protocol (see Rehabilitation Protocol and Figure 2).
Postoperative situation. Postoperative radiographs after Grika interposition arthroplasty with hinged external fixator (a, b); active and passive motion during hospitalization (c-f).
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fig2
The patient underwent Grika interposition arthroplasty (see surgical technique paragraph and Figure 1) followed by a suitable rehabilitation protocol (see Rehabilitation Protocol and Figure 2).
Direct postoperative radiograph showing the insufficient fracture fixation after previous surgery (a); the skin showing the scar following previous surgery (b); radiographs showing distal humeral malunion and generalized elbow joint osteoarthritis (c, d).
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fig3
He had malunion of the distal humerus of his dominant arm (Figure 3), accompanied with elbow stiffness (Figure 4), and evident signs of osteoarthritis were seen on radiographs (Figures 3(c) and 3(d)).
Preoperative situation and active elbow range of motion. Maximum of 80 degrees of flexion (a); no possibility of extension (b); sufficient pronation and supination (c, d).
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fig4
He had malunion of the distal humerus of his dominant arm (Figure 3), accompanied with elbow stiffness (Figure 4), and evident signs of osteoarthritis were seen on radiographs (Figures 3(c) and 3(d)).
Final postoperateive situation at 5 years of follow-up (a-d). Valgus axial deviation (e, f).
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fig5
Functional outcomes are shown in Figure 5.