Of eleven patients with tuberculosis of the elbow who were operated on
using a new technique, six were followed for two years or more. This
technique (which includes debridement and total synovectomy, excision of
the radial head, insertion of the triangularly shaped olecranon into a
correspondingly shaped hole in the distal end of the humerus, fixation of
the humerus and ulna with a single screw, medial and lateral
epicondylectomy, and anterior transposition of the ulnar nerve) provides
superior bone contact and firm internal fixation without the need for bone
grafts. Solid fusion resulted in the six patients who were followed for two
years or more. The only complications observed in all eleven patients were
transient ulnar-nerve hypoesthesia in one patient and a tourniquet
paralysis in an other, both of which resolved. The advantages of the
procedure are that the fixation is stable; bone-grafting is not required;
adequate joint debridement, including anterior synovectomy, is possible
after the radial head is excised; and to date no pseudarthrosis has
occurred.