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Fenestration Arthroplasty

elbow arthritis xray

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 CPT

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.

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