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Abstract
Purpose
Neuropathic arthropathy of the elbow is extremely rare and is characterized by painless destruction of the joint due to diminished proprioception. We report five cases of neuropathic arthropathy of the elbow with review of pertinent literature.
Materials and Methods
We analyzed records of five patients who were diagnosed with neuropathic arthropathy of the elbow. There were three men and two women with a mean age of 38.6 years (range, thirteen to fifty years). The conditions associated with the arthropathy were three cases of syringomyelia, one tabes dorsalis, and one neurofibromatosis. One patient was conservatively treated and was followed periodically and others underwent operative procedures. The mean duration of follow-up was 8.5 years (range, one to nineteen years). Changes of symptoms, range of motion (ROM), and functional satisfaction were assessed.
Results
The conservatively treated patient maintained the function of the elbow. In the surgically treated group, one case of ulnar nerve decompression and one case of osteosynthesis of the fractured olecranon showed improvement of symptoms, ROM, and function. But two patients who underwent reconstructive procedures had decreased ROM after complication of deep infection.
Figures and Tables
Fig. 1
Case 1. Plain roentgenograms reveal heterotopic ossification, small bony fragments, and diffuse subchondral sclerosis around the elbow joint (A and B).
Fig. 2
Case 3. Initial roentgenogram reveals the substantial absorption of medial humeral condyle (A). Resection arthroplasty was done for the control of infection after resection of fibroma, and it shows dislocation of the radial head (B). For the reduction of radial head, shortening osteotomy of radial shaft and annular ligament reconstruction were performed (C). At final follow-up, he complained of limitation in range of motion (D).
Fig. 3
Case 5. Plain roentgenogram reveals fracture of olecranon, diffuse small bony fragments, and ossified fragments (A). Open reduction and internal fixation was done. On postoperative 1 year, union of fracture site of olecranon was progressed, whereas radial head and both humeral condyle were resorpted increasingly (B). But she did not complain any discomfort for the function of her elbow (C and D).
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