Babovnikov AV Pryazhnikov DA, Rubekina LN Tsypursky IB, A. Smyslov Moscow State Medical Dental University, Department of Traumatology, Orthopedics and Military Field Surgery of the existing diversity techniques of operative treatment of fractures of the elbow led to their wide application without strict indications and contraindications. The absence of a single algorithm and standards of care patients This category provokes uncontrolled "creative" approach to choosing a method of treatment. The price of the operating surgeon error is too high because of significant technical difficulties in restoring stale or improperly fused elbow injury. Read additional details here: Senator of Massachusetts. Evaluation of poor clinical outcome of surgical treatment of patients with lesions elbow showed that the majority of cases the cause of pseudarthrosis is unstable fixation due to an underestimation of the need for operating surgeon Anatomic reconstruction of each bone fragment out of fear "Unnecessary" expansion of surgical approach or contact with the neurological structures, because of the difficulty of Anatomic location and the fear of neuropathic complications. When treating patients with false joints distal humerus is expedient to be guided by the following algorithm: 1) Define the initial range of motion in the elbow joint, neurovascular status, and signs of septic complications.
To clarify the scope and type of a false joint at the difficulties of interpretation of radiographs, it is advisable to perform an additional CT scan. Based on these data, pseudarthrosis classified as aplastic or hypertrophic. 2) A decision on the amount of surgery and is determined by operational access. In the case of aplastic false joint, planned way and the volume osteo-plastic substitutions. In implementing the surgical approach is advisable to make it through the old post-operative scar to reduce the risk of ischemic necrosis of the skin. Histories Data on previous surgical interventions on the areas concerned, the elbow is a wire for extra caution because of the possibility of transposition ulnar nerve or its involvement in scar-adhesions.