ARTHROPLASTY OF THE ELBOW

¹ Professor of Orthopaedic Surgery, Columbia University

The advantages of the method herewith proposed may be summarized as follows:

1. The approach gives the freest exposure possible without jeopardizing important structures. This point cannot be too highly emphasized because the very success of the operation depends upon the most meticulous care in the removal of all peripheral bone (especially in front of the joint) as well as the suture of the interposed fascia-fat graft.

2. It enables the surgeon to remove sufficient bone to insure complete freedom of motion without jeopardizing stability. Stability is brought about by the antagonistic pull of the flexors and extensors upon a lever whose fulcrum comes at the newly formed joint, the posterior arm of which (the olecranon) is long enough to allow sufficient antagonistic action of the triceps to bring this about.

3. Early immobilization without danger of separation or non-union of the ulnar parts is made possible by this use of the long, sliding, inlay olecranon-ulna graft, to which the insertion of the triceps is undisturbed, and the accurate mortise fit of this graft into its proper gutter.

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