Supine Elbow Arthroscopy for Post Traumatic Loose Bodies

Lee Hunter MD, MBA (Hunter Medical Founder and Chief Medical Officer)

December 2016

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Supine positioning for elbow arthroscopy is rapidly growing in popularity, given its comparative ease and many advantages over lateral or prone positioning. Intraarticular loose body removal is one of the most common indications for elbow arthroscopy.

52 YO RHDF with Traumatic Posteromedial Elbow Dislocation and Multiple Loose Osteochondral Fragments

The patient sustained a posteromedial elbow dislocation from a fall. Her injury x-ray and a post-reduction CT film are seen below.

Arthroscopy was performed with the patient supine using the ElbowLOC® Arm Positioning System. The coronoid fracture fragment was from the anterolateral aspect of the coronoid and devoid of soft tissue attachments. It was simply removed, as the anterior capsule remained attached to the intact coronoid. The small comminuted trochlea fragments could easily be seen arthroscopically, but were removed through a small arthrotomy due to their location immediately beneath the ulnar nerve.The elbow was stable after loose body removal, and no ligament repairs were required. The patient was treated with a controlled motion brace for 8 weeks and regained full motion with no pain.

The ElbowLOC® allows the surgeon to perform supine elbow arthroscopy while maintaining complete control of the forearm. This is a huge advantage versus other positioners. The ability to “dial in” the desired amount of static elbow extension makes posterior compartment arthroscopy particularly easier.

This case is another great example of how the ElbowLOC® simplifies and accelerates procedural times for many elbow surgeries and makes surgery easier for the surgeon, patient, and staff!