A 34-year-old male patient was admitted to our center. He had malunion of the distal humerus of his dominant arm (), accompanied with elbow stiffness (), and evident signs of osteoarthritis were seen on radiographs (Figures and ).\nThe study was approved by the hospital's Ethical Review Board, and it was conducted in accordance with the principles of the Declaration of Helsinki and its amendments. We fully informed the subject, and he gave his consent.\nThe patient underwent Grika interposition arthroplasty (see surgical technique paragraph and ) followed by a suitable rehabilitation protocol (see Rehabilitation Protocol and ). The external fixator which was used for initial support was removed 14 weeks after surgery.\nThe injured side (IS) and the noninjured side (NIS) were compared during the clinical follow-up. Function was evaluated with subjective quality of life measured by the Mayo Elbow Performance Score (MEPS) [].\nObjective function was evaluated by range of motion, flexion strength, and supination strength. A calibrated hydraulic dynamometer was used for the strength measurements. During these strength measurements, five measurements were taken by the same evaluator. The mean score of the last four was calculated as the first measurement was disregarded to avoid bias because of a learning curve caused by the patient's awareness.\nAt 1 year after surgery, both the MEPS and muscle strengths showed a difference in favor of the NIS. At 5 years of follow-up, the IS had a flexion strength of 98% of the NIS (28.9 N versus 29.5 N) and supination strength of 98% of that in the NIS (4.6 versus 4.7) and a MEPS of 100. Functional outcomes are shown in .\nThe patient was monitored for any postoperative complications.
Case 2. A 29-year-old male sustained an open olecranon fracture of the left elbow. Fixation of the fracture was done resulting in a 60 cm2 soft tissue defect. This was covered with a medial fasciocutaneous transposition flap based on a medial upper arm perforator. The donor site was skin grafted. Recovery was uneventful, and the patient's ROM at the elbow was recorded as 100° 8 months postoperatively ().