ANKYLOSED ELBOW IN EXTENSION

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CHERRY KOVOOR

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Sep 9, 2021, 12:53:05 PM9/9/21

to PAED ORTH INDIA

Dear Friends

Kindly give your opinion for this rather unfortunate pt.

13 yr old girl

Pt had a fall in Nov 2020 treated with crepe bandage by an ortho surgeon .Pt was reviewed after 3 weeks-couldn’t extend the elbow, x-ray was taken and told something wrong- Pt then saw another orthopaedic surgeon who advised active exercises. Now couldn’t flex the elbow- then saw third ortho surgeon who took x-ray and MRI-told cartilage loss- nothing can be done

Examination – R elbow fixed at 30 degree flexion ,no further movement. Pronation -full ,supination till mid prone, diffuse synovial thickening

x-rays- ankylosed elbow with radial head dislocation, old fishtail deformity- distal humerus

MRI -shows synovial thickening

I think it is some low grade infection / tuberculosis

I think her upper limb is now pretty useless- I was thinking EXCISON ARTHROPLASTY as described by Prof Tuli[ attached pics] and mobilization with aid of hinged external fixator [Ilizarov] to give some movement and better function if possible. Also a synovial biopsy at time of surgery

Attaching clinical and radiology pics along with illustration from Prof Tuli

Regards

DR CHERIAN KOVOOR

KOCHI

INDIA

ars mri1.jpg

ars MRI2.jpg

ars18-8-21 LAT.jpg

arsh 18-8-21AP.jpg

arsh1.jpg

tuli.jpg

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