Elbow fusion 1Elbow fusion 2






Failed arthroplasty

Segmental bone loss / high energy injuries

Tumour resection

Neuropathic joints


Chacot Elbow

Unstable Charcot elbow




Significant functional deficit

Shoulder and wrist cannot compensate for the loss of the hinge




Rheumatoid arthritis

- high failure rate

- affects other joints poorly





Can use elbow brace pre-operatively to find best position for that patient


30 - 40 degrees

- cosmetically more acceptable

- helps with transfers and toileting

- helps with work


90 degrees

- helps with feeding / washing face



- depends on preference

- typically neutral to allow shoulder to compensate

- computer workers may prefer hand slightly pronated


Tang et al J Hand Surg Am 2001

- simulated fusion at varying degrees in volunteers

- functional scores peaked at 110 degrees of flexion




External fixation


Typically for combat related / extreme open injuries


Sheean et al Mil Med 2016

- 5 patients with severe combat related injuries

- circular external fixator

- mean time injury to arthrodesis surgery was 305 days

- mean time to achieve fusion was 700 days

- union in all 5 patients


Internal fixation with posterior plating


Koller et al J Should Elbow Surg 2008

- 14 patients

- multitude of indications

- mean number of reoperations 1.4

- skin necrosis / persistent infection / hardware failure / periprosthetic infections / nonunion

- 6 patients had persistent pain


Failed infected elbow arthroplasty salvage


Otto et al J Shoulder Elbow Surg 2014

- 5 fusions for infected failed elbow arthroplasty

- 2 fibrous unions

- 3 failed unions

- all patients required at least one reoperation

- 2 patients ended up with resection arthroplasty


Surgical technique


Elbow arthrodesis technique