[Treatment of elbow joint ankylosis by repair of articular surface with periosteal autograft].

ABSTRACT

OBJECTIVE: To evaluate the clinical effect of periosteal autograft in repair of ankylosis of elbow joint. METHODS: From May 1985 to November 1999, 18 cases of elbow joints ankylosis (6 cases of osteo-ankylosis, 12 cases of fibroankylosis) were treated by repairing articular surface with periosteal autografting. Out of 18 cases, 13 were caused by old dislocation and fracture of elbow joints, 3 by late rheumatoid arthritis, and 2 by old total joint tuberculosis. In this surgical approach, periosteum from upper end of tibia was transplanted into articular surface after correction of the elbow joint from ankylosis deformity, and continuous passive or active movement of the operated joint was adopted with skeletal traction through olecranon of ulna for 4 weeks after operation. All of the cases were followed up for 1-9 years, 5.2 years on average, before clinical evaluation. RESULTS: The elbow joints in 11 cases were restored to normal, the joints in 4 cases obtained active movement in the range of 100 degrees-0 degree, and the joints in the other 3 cases could only have limited movement because of severe muscular atrophy. CONCLUSION: The articular surface in arthroplasty of elbow joint ankylosis could be effectively repaired by periosteal autograft, and the function of the joints could be obviously improved by continuous movement of the joints after operation with skeletal traction.