Prosthetic replacement for coronoid deficiency: report of three cases

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• 作者：Enrico Bellato ; MD^a ; ^b ; Shawn W. O'Driscoll ; PhD ; MD^a ; ^{odriscoll.shawn@mayo.edu}
• 关键词：Level IV ; Case Series ; Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：26
• 期：3
• 页码：382-388
• 全文大小：1157 K
• 卷排序：26

文摘

Persistent elbow instability associated with coronoid deficiency is a difficult condition to treat. Several surgical techniques have been described for coronoid reconstruction, but the resulting outcomes have been unpredictable. We hypothesized that a coronoid prosthesis could restore elbow stability.MethodsA nonanatomically shaped metallic coronoid prosthesis was custom designed for each of 3 patients. Each had a chronic fracture-subluxation with persistent instability, deficiencies of the coronoid, and compromise of the radial head. Each patient had undergone 2 to 4 prior failed operations.ResultsAt a mean follow-up of 11 years (range, 10-12), 2 of the 3 patients were completely pain free; the third had a visual analog scale pain score not greater than 3/10. All 3 maintained a stable joint, although a functional range of motion was not able to be maintained in any. Two patients rated themselves “improved” and 1 patient rated himself “almost normal” on the Summary Outcome Determination scale. All radiographic follow-up showed the coronoid prosthesis in proper position without loosening.ConclusionProsthetic replacement of the coronoid appears successful in restoring stability in chronically unstable elbows with coronoid deficiency.