Total elbow arthroplasty in the treatment of posttraumatic conditions of the elbow

Posttraumatic arthritis, arthritis secondary to instability, and nonunion o r malunion about the elbow may: be treated by various methods. Recommended first-line treatment in the younger, more active patient population is nonp rosthetic techniques. Total elbow arthroplasty should be considered primari ly as a salvage procedure for these patients. Careful patient selection wil l determine whether total elbow arthroplasty is an acceptable choice, despi te its inherent risks and complications, Prosthetic replacement is more app licable for patients with low physical demands who are older than 60 Sears of age with pain, stiffness, and/or instability of the elbow who will more likely be able to comply with postoperative rehabilitation and strict activ ity restrictions. Previous incisions, gross instability, periarticular fibr osis with ulnar nerve encasement, loss of bone and/or soft tissue, and prev ious infections represent obstacles for prosthetic reconstruction in these patients, The use of unlinked total elbow designs require good bone stock w ith little deformity and stable capsuloligamentous support, which uncommonl y is found in elbows after trauma. Linked semiconstrained prostheses have b een used most frequently with good short-term results reported in the liter ature. Reported failure rates after longer followup have led to a search fo r improvements in prosthetic design, cementing techniques, and better patie nt selection.