Interpositional Arthroplasty With Dermal Grafting and Hinged External Fixator for Elbow Osteoarthrosis Associated With Stiffness in Young Adults

Introduction Elbow stiffness can be disabling when performing activities. Surgery is indicated when conservative treatment fails. In older patients, the most appropriate surgical option is total elbow arthroplasty. However, in younger patients, the choice of surgery remains a topic of discussion. Materials and methods This study was a retrospective case series with a five-year follow-up, evaluating the outcomes of interpositional arthroplasty with dermal grafting and a hinged external fixator for elbow osteoarthrosis associated with stiffness in young adults according to the Mayo Elbow Performance Score (MEPS), the quickDASH score, the Visual Analogue Scale (VAS), and range of motion (ROM). Outcomes were assessed preoperatively and at 3, 6, 12, 24, and 60 months postoperatively. Imaging evaluations were performed preoperatively and at the 60-month follow-up. All complications were documented. Results We evaluated 40 patients. The MEPS increased from 42.6 ± 12.2 to 70.3 ± 18.6 (p < 0.001). The quickDASH score decreased from 43.4 ± 3.2 to 25.3 ± 9.7 (p < 0.001), and the VAS score decreased from 8.7 ± 2.0 to 3.7 ± 2.7 at the end of follow-up (p < 0.001). The flexion-extension arc increased from 49˚ ± 27˚ to 92˚ ± 29˚ (p < 0.001). Imaging studies showed a reduction in joint narrowing, a decrease in osteophytes, a higher radiographic classification of arthrosis, and fewer loose bodies. A total of 65% of patients experienced transient complications, while 5% had complications requiring reoperation, including arthrodesis and total elbow arthroplasty. Conclusions Interpositional arthroplasty with dermal grafting and a hinged external fixator for elbow osteoarthrosis associated with stiffness in young adults significantly improves clinical functional scale scores, ROM, and radiological appearance at the five-year follow-up. Despite the high rate of complications, most were transient and manageable, with only a small percentage of cases (5%) requiring surgical reintervention. The procedure demonstrated sustained functional benefits over time, with early improvements in pain and mobility stabilizing in the long term.