Interposition Arthroplasty in an Acute Setting to Treat Unexpected Denuded Distal Humerus Articular Cartilage After AO 13C2.2 Distal Humerus Fracture, Surgical Technique, and a Case Report.

Abstract

Restoring elbow joint motion is paramount for upper extremity optimum function. In end-stage elbow disease and stiffness, total elbow arthroplasty is the recommended option for older patients; however, for younger, highly demanding patients, interposition arthroplasty (IPA) is the management option of choice. We report a case of an 16-year-old female patient who presented after she had an open-grade IIIA, type AO 13C2.2 distal humerus fracture, which was managed initially by debridement and a cross-elbow external fixation. The decision was made to manage the fracture by open reduction and internal fixation through a posterior approach, and after performing an olecranon osteotomy, the surgeon found that the distal humerus segment was denuded of articular cartilage, so a decision was made after consulting the patient's parents to perform an IPA using fascia lata. At the final follow-up after 16 months, the fracture united completely, and the elbow ROM was from 15° to 120°. Interposition arthroplasty is a valid option to manage unexpected denuded distal humerus articular cartilage while managing distal humerus fractures.