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European Journal of Orthopaedic Surgery & Traumatology
Published in: European Journal of Orthopaedic Surgery & Traumatology 3/2020

01-04-2020 | Rheumatoid Arthritis | Original Article • ELBOW - TRAUMA

Digastric olecranon osteotomy a new approach to the elbow: retrospective study of 24 Coonrad–Morrey® total elbow arthroplasty at 30-month follow-up

Authors: Pascal Cottias, Philippe Leclerc, Amine Zaoui, Abdel Massih Abouchaaya, Raphiq Khallouk, Philippe Anract

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 3/2020

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Abstract

Background

Digastric olecranon osteotomy approach allows an excellent articular exposure and preserves principal vascular supply and the continuity of the extensor apparatus. The aim of this study was to assess the early clinical and radiological outcome after total elbow arthroplasty implanted from a digastric olecranon osteotomy approach.

Methods

We retrospectively enrolled 22 patients (two men and twenty women) treated with 24 Coonrad–Morrey® total elbow arthroplasty implanted from a digastric olecranon osteotomy approach in Island of France (Paris, Argenteuil and Saint-Denis). The mean age was 80 years (50–96). We treated 20 fractures; according to AO classification, seven patients suffered from a C1 fracture, seven from a C3 and C2, two from malunions, and four from rheumatoid arthritis. The mean time of follow-up was 30 months (6–132). Clinical outcomes were assessed with the Mayo elbow performance score. We evaluated triceps strength and radiographic healing.

Results

At the latest follow-up, the average flexion arc was 23° (5°–50°) to 112° (95°–130°). The Mayo elbow performance score averaged 92 points (75–100). The mean strength of the triceps in extension and flexion was, respectively, 1.9 and 4.7 kgs. All elbows were stable. A single immediate post-operative wound infection was reported and did not require any surgical revision. Radiological consolidation of the olecranon osteotomy was assessed in sixteen patients between 8 and 16 weeks. Heterotopic ossifications were noted in one elbow. One patient had an elbow dislocation by fracture of the axe’s component.

Conclusion

The early clinical and radiological outcomes are promising and support the use of digastric olecranon osteotomy for the implantation of total elbow arthroplasty.

Level of evidence

Treatment study, level IV.
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Metadata
Title
Digastric olecranon osteotomy a new approach to the elbow: retrospective study of 24 Coonrad–Morrey® total elbow arthroplasty at 30-month follow-up
Authors
Pascal Cottias
Philippe Leclerc
Amine Zaoui
Abdel Massih Abouchaaya
Raphiq Khallouk
Philippe Anract
Publication date
01-04-2020
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 3/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-019-02590-5

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