PMC5537439_01
Preoperative ranges of motion of the elbow. A: The range of motion of the left elbow was 100  for flexion at the first visit to our hospital. B: The range of motion of the left elbow was -10 for extension at the first visit to our hospital. C: When the patient's shoulder was elevated, she could not hold it up against her own arm weight and therefore her forearm had a curvature due to her own arm weight at the site of pseudarthrosis.
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On the first examination, the range of motion of the elbow was 120  in flexion, -10  in extension, 60  in pronation, and 60  in supination, and pronation and supination were compensated by the psedoarthrosis region (Fig. 1A and B). The psedoarthrosis region was unstable and unable to support the forearm weight, and it was about 30  curved while upper arm lifting (Fig. 1C).
Preoperative radiographs. A: The radiographic frontal view of forearm and elbow at the first visit to our hospital. B: The radiographic lateral view of forearm and elbow at the first visit to our hospital.
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Postoperative radiographs. A: The radiographic frontal view of forearm and elbow after the surgery. B: The radiographic lateral view of forearm and elbow after the surgery.
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A metaphyseal plate (DePuy Synthes, Tokyo, Japan) was curved by 30  backward to position the elbow joint at 135  flexion, and the ulna was fixed with this plate (Fig. 3A and B).
Postoperative outcomes at 7 years follow-up. A: The range of motion of the left elbow was 135  for flexion at 7 years follow-up. B: The range of motion of the left elbow was -30  for extension at 7 years follow-up. C: The radiographic frontal view of forearm and elbow at 7 years follow-up. D: The radiographic lateral view of forearm and elbow at 7 years follow-up.
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At 7 years after surgery, the range of motion of the elbow was 130  in flexion, -30  in extension, 60  in pronation, and 30  in supination, VAS was 2/10, and the Q-DASH score 31.82/100, showing improvement (Fig. 4A and B). No progression of osteoarthritis of the elbow was observed (Fig. 4C and D).