Reconstruction of massive coronoid defects associated with persistent elbow dislocation using autologous bone grafts&nbsp;

doi:10.13418/j.issn.1001-165x.2025.4.03

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (4) : 379-386. DOI: 10.13418/j.issn.1001-165x.2025.4.03

Reconstruction of massive coronoid defects associated with persistent elbow dislocation using autologous bone grafts

Xue Yiqing^1,2,3,4,5, Lu Jiuzhou^1,2,3,4,5*, Li Shulin^1,2,3,4,5, Yang Kangqi^1,2,3,4,5, Xu Jianguang⁶

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Abstract

Objective To evaluate the clinical efficacy of using autologous iliac bone and radial head grafts for the reconstruction of massive coronoid defects associated with persistent elbow dislocation to restore joint stability. Methods A retrospective analysis was conducted to evaluate the clinical outcomes of 6 patients who underwent reconstruction of severe coronoid defects using autologous iliac bone or radial head grafts. The patients had an average age of 36.2 years (28-57 years). All cases involved severe post-traumatic coronoid defects with chronic elbow dislocations, characterized by significant articular surface damage, collapse, and severe post-traumatic arthritis. Results The average interval between injury and reconstructive surgery for patients was 26.8 months (11-60 months). 5 patients received autologous iliac bone grafts, and one patient received an autologous radial head graft. Among them, 2 patients simultaneously underwent radial head replacement, 2 underwent Box-loop reconstruction of the collateral ligaments, and one underwent lateral collateral ligament reconstruction. The average follow-up duration was 26.5 months (1-88 months). 5 patients who were followed for more than 3 months, have achieved bony union according to CT scan. One case exhibited graft absorption. Residual elbow stiffness was observed in 5 patients postoperatively, 3 of whom underwent secondary arthroscopic elbow release, with 2 achieving satisfactory functional recovery. All patients demonstrated significant improvement in the Mayo Elbow Performance Score compared to preoperative values. Conclusions The use of autologous iliac bone and radial head grafts to reconstruct massive coronoid defects associated with persistent elbow dislocation has demonstrated reliable bone healing and joint stability, with a low incidence of joint re-dislocation or graft absorption. Combined with arthroscopic release procedures, this operation can restore elbow function to meet the demands of daily activities, obviate the need for joint replacement, and improve patient outcomes.

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Coronoid deficiency / / / Coronoid reconstruction / / / Autogenous bone graft / / / Joint dislocation

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Xue Yiqing, Lu Jiuzhou, Li Shulin, Yang Kangqi, Xu Jianguang. Reconstruction of massive coronoid defects associated with persistent elbow dislocation using autologous bone grafts [J]. Chinese Journal of Clinical Anatomy. 2025, 43(4): 379-386 https://doi.org/10.13418/j.issn.1001-165x.2025.4.03

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