Fenestration Arthroplasty

64y/o RHD male with progressive arthritis of right elbow with main complaint of loss of motion. Physical exam revealed ROM from 40-85 degrees. A/P and lateral pre-operative views shown.

Fenestration Arthroplasty Technique

• (ulnohumeral arthroplasty) (Outerbridge
• need trephine drill, kerosins, kregels, curettes, osteotomes
• slightly medial midline incision from olecranon 5cm proximal
• dissection to triceps fasia
• elevate skin medially until medial border of biceps is encounter
• free ulnar nerve and be warry of branches of medial antebrachial cutaneous nerve
• elevate triceps off capsule and humeral shaft
• after adequate expose, excise posterior capsule and remove posterior olecranon osteophytes and clearly define olecranon fossa
• make fenestration with trephine, clear anteriorly with kerosins
• elevate anterior capsule with kregels
• flex elbow to identify coronoid osteophtye and excise
• evaluate ROM, remove loose bodies etc
• close skin.

A/P and lateral post operative views. Patient had post-operative ROM 10-120 degrees.