title: A modified approach for elbow arthroscopy using an adjustable arm holder.
abstract: BACKGROUND
  Position shifting from elbow arthroscopy to open surgery could complicate the surgical procedures; patient safety and risks of contamination are of concern. The aim of this study is to retrospectively assess the safety and efficacy of elbow arthroscopy in 32 elbows of 32 patients using a modified arm holder to facilitate subsequent open surgery in supine position.
  
  
  METHODS
  We performed a retrospective study in arthroscopy of the elbow performed with patients in the supine position under general or regional anesthesia. Arthroscopic indications were intraarticular lesions with or without second disorders. The operated arm was securely supported using an adjustable arm holder, which allowed a second surgical procedure without repositioning the patient. We recorded arthroscopic findings, clinical outcome, and complications for all patients. The average duration of follow-up was 17.1 months. Functional assessment was based on the Mayo Elbow Performance Score.
  
  
  RESULTS
  All patients had either good or excellent results with a mean Mayo Elbow Performance Score of 89.2 ± 7.2. Final motion arc averaged 113.3 ± 11.8; residual motion limitation was noted in 2 patients with preoperative ankylosis. No complications were observed immediately after surgery or during follow-up except transient paresthesia along medial cutaneous nerve in 2 patients. A total of 17 patients (53.1%) underwent other surgeries (19 procedures) after arthroscopy; 16 of these surgeries were open elbow procedures including ligament repair (7), ligament reconstruction (5), and ulnar nerve transposition (4). The average time for arthroscopy was 45.2 min; the time interval between the end of arthroscopy and the start of the second surgery procedure averaged 6.5 min.
  
  
  CONCLUSIONS
  Arthroscopy of the elbow using an adjustable arm holder with the patients in the supine position was safe and efficacious. This procedure eliminates the need for repositioning the patient and thus may facilitate subsequent concomitant surgical procedures.
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou and University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, Republic of China. alvinchen@cgmh.org.tw.
authors.forename: Alvin Chao-Yu
authors.initials: AC
authors.lastname: Chen
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou and University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, Republic of China.
authors.forename: Chun-Jui
authors.initials: CJ
authors.lastname: Weng
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou and University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, Republic of China.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chiu
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou and University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, Republic of China.
authors.forename: Shih-Sheng
authors.initials: SS
authors.lastname: Chang
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou and University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, Republic of China.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou and University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, Republic of China.
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Chan
mesh_terms: D000328:Adult; D001132:Arm / Q000000981:diagnostic imaging / Q000601:surgery; D001182:Arthroscopy / Q000295:instrumentation* / Q000379:methods; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D056888:Patient Positioning / Q000295:instrumentation* / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D016683:Supine Position