Abstract
Since November 1984, semi-constrained total elbow replacement (STER) has been used for treating severely destructed RA elbows in our department. Eight elbows in 8 patients, 1 male and 7 female, were treated with STER (6 Schlein, 2 Coonrad-IIB) . The average age at operation was 64 years, and the follow-up term ranged from 7 months to 43 months (an average of 22.7) . Two RA-affected elbows which had sustained supracondylar fracture of the humerus were treated with STER to achieve early motion.
The average flexion improved from 116° to 137°, 34 to 44° in pronation and 59 to 67°in supination. However, the average loss of extension increased from 23°to 34°. Using the elbow-evaluating system of the R. B. Brigham Hospital, an average preoperative score of 27.1 had improved to 67.8 at follow-up. The pain was reduced markedly (11.4 to 45.7 ), but the function of the upper limb was not improved that much. No infection or any loosening of the STER has been encountered, but one case resulted, 14 months postoperatively, in a skin defect at the olecranon due to thinned subcutaneous tissue and the excessive size of the prosthesis. The lesion was completely healed by a fasciocutaneous flap.
The authors think that STER is indicated in cases of RA elbow either with ligamentous instability or with extensive bone loss
