.. Figure selleck chemicals 2 Radiological assessment with CT scan of early cubarthritis shows the posterior impingement in extension (a). Pre- (b) and postoperative (c) X-rays of the perforation of the distal humerus. Figure 3 Intraoperative images of the perforated humerus (seen from the posterior compartment with a view on the anterior compartment of the joint) demonstrating the free movement of the coronoid process in the created hole. Because of the easy rehabilitation and the low impact on the patient, the threshold is low and the arthroscopic Outerbridge-Kashiwagi is now more and more used in young patients, even in sportsmen [9]. This brings up the question as to what level the humerus is thus put at risk in their high-demand population. In a former study, we looked at the fracture risks in cadaver specimens [10].
We concluded that the fracture lines are displaced from humeral shaft fractures towards intraarticular column fractures in standard posterior forces on the distal humerus [11]. The columns also appear to be about 40% easier to break. In a clinical setting, bone remodeling is obvious after 6 weeks on radiological examinations, and although the hole remains visual, the columns are surrounded by cortical bone and the fracture risk most likely has disappeared. However, in the immediate postoperative period, patients need to be prompted to reduce sports activities, since bone strength of the distal humerus does not guarantee such a high reserve if maximal muscle forces are produced [2, 12]. 7. Results Minami reported good results with the open procedure reporting initial satisfactory results in over 90% in 1985 [4].
After a longer followup (9�C16y), however, these results decreased to 55% in 44 cases in 1996. These findings demonstrate a temporary result in most cases and this is confirmed by many reports. Although in short-term studies good to excellent outcomes are reported, long-term follow-up studies Cilengitide demonstrate a limited recurrence of the complaints, since obviously the underlying disease remains present. Relatively, short-term results after about 2 to 5 years as reported by Morrey in 1992 showed similar results of 80% success rate in 15 elbows, 81% in 36 elbows by Forster in 2001, 74% in 46 elbows by Antuna in 2002, 88% in 17 elbows by Sarris in 2004, and 87% in 16 elbows by our group in 2004 [5, 13�C16]. The Mayo Performance Index improved from 63 to 88 and range of motion from 94�� to 114��. However, in 2003 Philips presented a good outcome even after a longer followup with a minimum of 5 years with still a 85% success rate in 20 elbows [17], although results deteriorated somewhat after a longer followup, and surgical benefits were maintained in 80%. Complications are uncommon in elbow arthroscopy with an incidence of less than 0.