title: Restoring independency with an osteochondral graft of the navicular for coronoid process reconstruction.
abstract: BACKGROUND
  The coronoid is a crucial element for elbow stability. In case of posttraumatic instability or reduced range of motion, a complex reconstruction might be necessary.
  
  
  METHODS
  We present the case of a polytraumatized patient with complex upper extremity injury and initial poor outcome. Subluxation after initial surgery was treated by sublime tubercle reconstruction with a corticocancellous iliac crest graft. Due to massive ossification, the elbow remained stiff and the paraplegic patient was unable to use a manually propelled wheelchair. After arthrolysis, the unstable elbow was treated with an osteocartilaginous graft from the navicular of the foot as well as ulnar and radial collateral ligamentoplasties. At the time of follow-up, the patient had a stable joint and was able to independently perform activities of daily living.
  
  
  CONCLUSIONS
  An autologous navicular graft seems to be an excellent option for our paraplegic patient as the shape matches the sublime tubercle of the ulna.
authors.affiliation: Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Stefanie.erhart@tirol-kliniken.at.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Erhart
authors.affiliation: Department for Trauma Surgery, Landeskrankenhaus Hall, Milser Strasse 10, 6060, Hall in Tirol, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Lutz
authors.affiliation: Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Deml
authors.affiliation: Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Sitte
authors.affiliation: Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Angermann
mesh_terms: D000203:Activities of Daily Living; D064592:Autografts; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013639:Tarsal Bones / Q000601:surgery; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000150:complications / Q000601:surgery*
keywords: Complex elbow trauma; Joint reconstruction; Ligamentoplasty; Navicular graft; Osteochondral graft