The elbow and distal humerus are unusual sites for primary bone tumours or metastatic disease. 1 Before the advent of limb-salvage surgery around 1980s, amputation or arthrodesis was the primary treatment for tumours of the upper limb and the ultimate result was not usually satisfactory. The outcome after reconstructive surgery improved with advances in imaging, staging of the bone tumours, chemotherapy and advancements in the prosthesis designs for arthroplasty. Now preservation of the upper limb with functional reconstruction with arthroplasty has become the standard treatment for patients with bone tumours. 2, 3 Total elbow arthroplasty has been used extensively for malignancy, rheumatoid arthritis, osteoarthritis and trauma. 4-6 Total elbow arthroplasty has continued to evolve over time. Elbow implants may be linked or unlinked. Unlinked implants are attractive for patients with relatively well preserved bone stock and ligaments, but many favor linked implants, since they prevent instability and allow replacement for a wider spectrum of indications. 7-9 We present our experience of reconstruction with a custom-made elbow endoprosthesis (Bakshi's floppy Hinge Semi-constrained linked Prosthesis) after resection of giant cell tumour of the distal humerus with follow up of 6 and half years.
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