Reconstrucción de defecto troclear lateral traumático con autoinjerto de cabeza radial / Reconstruction of a traumatic lateral trochlear defect with a radial head autograft

Objetivo. Presentar el resultado de la reparación de un defecto troclear severo en el codo mediante un autoinjerto óseo con la cabeza radial ipsilateral, como una alternativa a la artroplastia total. Caso clínico. Presentamos el caso de un paciente, que sufrió una fractura abierta de codo con pérdida ósea importante en la región humeral distal, y que precisó tras la estabilización inicial una cirugía de reconstrucción mediante autoinjerto ipsilateral de cabeza radial. Discusión. Las fracturas abiertas de codo son infrecuentes. Cuando existe un defecto troclear severo, las alternativas quirúrgicas son la artroplastia total de codo, con unos resultados a corto y medio plazo que parecen ser insuficientes, o la artrodesis. Creemos que la reconstrucción del defecto empleando un autoinjerto de cabeza radial homolateral es una alternativa más funcional que los otros procedimientos descritos. Conclusión. La reconstrucción con cabeza radial ipsilateral de los defectos trocleares laterales es una técnica, que al contrario que la artrodesis, conserva la funcionalidad sin los inconvenientes de la artroplastia total de codo (AU)

Objective. To report the result of a severe articular defect secondary to a complex open fracture of the distal humerus, using the ipsilateral radial head as a bone autograft for the trochclear region as an alternative to total arthroplasty. Case report. We describe a patient who suffered an open fracture of the elbow with bone loss in the distal humeral region and, after the initial stabilisation surgery, needed a reconstruction with an ipsilateral radial head autograft. Discussion. Open fractures of elbow are rare. When there is a severe trochlear defect, surgical options are total elbow arthroplasty, where the short and medium term results appear to be insufficient, or elbow arthrodesis. We believe that reconstruction of the defect using an ipsilateral radial head autograft is a more functional alternative than the other procedures described. Conclusion. Radial head reconstruction with ipsilateral lateral trochlear defects is a technique that, unlike fusion, preserves functionality without the problems of total elbow arthroplasty (AU)

[Reconstruction of a traumatic lateral trochlear defect with a radial head autograft]. / Reconstrucción de defecto troclear lateral traumático con autoinjerto de cabeza radial.

OBJECTIVE: To report the result of a severe articular defect secondary to a complex open fracture of the distal humerus, using the ipsilateral radial head as a bone autograft for the trochclear region as an alternative to total arthroplasty. CASE REPORT: We describe a patient who suffered an open fracture of the elbow with bone loss in the distal humeral region and, after the initial stabilisation surgery, needed a reconstruction with an ipsilateral radial head autograft. DISCUSSION: Open fractures of elbow are rare. When there is a severe trochlear defect, surgical options are total elbow arthroplasty, where the short and medium term results appear to be insufficient, or elbow arthrodesis. We believe that reconstruction of the defect using an ipsilateral radial head autograft is a more functional alternative than the other procedures described. CONCLUSION: Radial head reconstruction with ipsilateral lateral trochlear defects is a technique that, unlike fusion, preserves functionality without the problems of total elbow arthroplasty.