%0 Journal Article %T Modification of Baksi sloppy hinge elbow to minimize the stresses at the humeral bone cement interface- An early experience %A Baksi D %J Indian Journal of Orthopaedics %D 2005 %I Medknow Publications %X Background : Baksi sloppy hinge elbow is an all metal prosthesis having 7 0 - 10 0 varus - valgus inherent laxity at the hinge section with minimal motion bearing contact area. Due to the presence of laxity at it¡äs hinge section, any strain on the prosthesis dissipates primarily to the surrounding soft tissues thus protecting the cement bone interfaces. However, from our long term clinical experiences on the use of our sloppy hinge design since 1984 and the knowledge of literature review of the results of using other semi-constrained (sloppy) or unconstrained designs, it was observed that radiolucency or loosening at the bone-cement interface occurred mainly around the humeral stem in the long run due to the continued effect of rotational torque of forearm and hand. Hence, an attempt in the improvement of the design concept is being made. Methods : In this respect one flange each of one cm height and breadth and three mm thickness has been incorporated on either sides of the shank of humeral stem of the sloppy hinge at medio-lateral (coronal) plane which will be seated in the corresponding longitudinal groove cut on either side of humeral shaft extending from its transverse cut end to become single assembly during the rotation of humerus. Results : The preliminary results of clinical application of the modified sloppy hinge elbow in ten cases are found satisfactory. Conclusion : The cyclical compression and distraction forces during flexion and extension of the elbow will be distributed over the larger bony area of lower end of humerus where flanges of the humeral shank being seated. The rotational torque effect of forearm and hand particularly with the arm in abduction will be minimised at the humeral bone cement interface as the humerus and the prosthetic stem act as a single assembly by the snugly fitting of the prosthetic flange in the humural shaft %K Mediolateral flange at humeral shank %K Baksi sloppy hinge elbow. %U http://www.ijoonline.com/article.asp?issn=0019-5413;year=2005;volume=39;issue=4;spage=240;epage=243;aulast=Baksi