SHORT-TERM COMPLICATIONS OF THE LATERAL APPROACH FOR NONCONSTRAINED ELBOW REPLACEMENT - FOLLOW-UP OF 50 RHEUMATOID ELBOWS

We reviewed 50 capitellocondylar elbow replacements performed by the l ateral approach in 42 rheumatoid patients, at a median follow-up of th ree years. There were two major and 17 minor complications; 18 were ea rly and one was late. Eight elbows required reoperation: soft-tissue s urgery was performed in seven and prosthesis removal in one because of a deep infection. There were few problems of instability, but one pat ient sustained a traumatic dislocation which was stabilised after liga ment reconstruction, Wound healing was delayed in two of five elbows w hich had been immobilised postoperatively for only five days, but heal ing was rapid in 45 elbows immobilised for 12 days. There was transien t ulnar-nerve palsy postoperatively in 11 patients, with permanent pal sy in three, All elbows were painfree or only slightly painful at foll ow-up; 49 were stable and 43 had a range of motion sufficient for acti vities of daily living, Radiological loosening of the humeral componen t was suspected in one asymptomatic elbow. The lateral approach is rec ommended for use with the capitellocondylar type of prosthesis in rheu matoid elbows with reasonably well-preserved bone stock.