Arthrodesis of the salvage elbow.

An elbow arthrodesis was performed as a salvage procedure in seven patients with an open elbow arthrosis resulting from open trauma and the multiple surgeries that had followed. Patients had undergone an average of four previous elbow operations since their initial injury. Patients had pain, limited motion and instability that seriously compromised ipsilateral upper extremity function. Hardware was placed posteriorly in five patients, and in two patients with predominantly posterior pathology and infection, it was placed anteriorly. All but one case was fused at 90 degrees of elbow flexion. Wounds were all left open and spontaneously healed by secondary intention. Six patients were available for an average follow up of 4 years. Time to fusion ranged from 4 to 9 months (mean 6 months). Patients were graded in terms of relief of symptoms, clinical fusion, radiographic fusion, return to employment, wound healing, shoulder and hand function, and forearm rotation. Three patients had an excellent result, two good, and in one, the result was fair. In our view, the surgical procedure of choice for a salvage elbow is an elbow arthrodesis.