Milch surgery

Recurrent elbow dislocation is rare, the main reasons are: 1 ulnar olecranon deformity, mostly due to ulnar coronoid process fracture, a small number of ulnar olecranon dysplasia. The 2-foot, temporal collateral ligament is unstable and the elbow joint is slack. Some scholars believe that posterolateral instability is a common cause. Surgery treatment of the former mainly used bone block. The latter performed ligament reconstruction. Treatment of diseases: joint dislocation Indication Milch surgery is available for: Recurrent posterior dislocation of the elbow, ulnar coronoid deformity. Surgical procedure Incision The elbow closes the inside incision. About 10cm long, cut the skin, subcutaneous tissue, separate the cephalic vein, and cut the lateral fascia to expose the biceps tendon and retract outward. 2. Exposing the joint On the inside of the biceps, the deep fascia and the biceps aponeurosis are cut. The radial artery and the accompanying vein are freed and then retracted outward, and the median nerve is retracted inward. In this gap, the coronoid process is removed, the diaphragm is separated, and the switch capsule is longitudinally cut to expose the joint and coronoid process. A hole was drilled in the coronoid process with a 6 mm drill bit to reach the dorsal side of the ulna. A 3.5 cm long bone graft was taken from the humerus to the ulnar coronoid process, and the elbow joint was flexed as much as possible. 3. Stitching After bone grafting, the blood vessels and nerves are returned to the original position, and the height of the bone mass is appropriately trimmed so as not to damage the blood vessels and nerves. The joint capsule and sarcolemma are sutured. The slit is layered. complication The bone graft is absorbed and dislocated.