Good outcome after elbow hemiarthroplasty in active patients with an acute intra-articular distal humeral fracture

Al-Hamdani, Ali; Rasmussen, Jeppe Vejlgaard; Sørensen, Anne Kathrine Belling; Ovesen, Janne; Holtz, Kenneth Brian; Brorson, Stig; Olsen, Birgit Anette

doi:10.1016/j.jse.2018.10.018

Cited by 32 publications

(31 citation statements)

References 18 publications

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“…Distal humeral fracture is the most usual upper limb fracture in adolescents, with an incidence of about 60% in all elbow fractures [1]. Cubitus varus deformity, as the most common complication of the distal humeral fractures in adolescents, accounts for approximately 30% to 58% [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

et al. 2019

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Background: This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods: Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results: Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents' excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions: The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

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Section: Introductionmentioning

confidence: 99%

Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

et al. 2019

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“…Eleven studies (N ¼ 163 patients) were included in the systematic review (Table 1). 1,3,4,6,11,[13][14][15][16][17][18] The publication date ranged from 2005 to 2019. The mean age (SD) was 67 (10) years, with patients ranging from 29 years to 90 years of age.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…With DHH, there is no polyethylene wear, periprosthetic fracture or loosening around the ulnar component or un-coupling of the linkage, which is a common reason for TEA failures. 1,[6][7][8][9] Additionally, DHH eliminates polyethylene particulate debris, 2 and may be more suitable for active patients or those intolerable to weight lifting restrictions required in TEA. 4,10,11 This study aims to systematically review the literature and report the indications, outcomes and adverse events (AE), and complications of DHH.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and complications of distal humeral hemiarthroplasty for distal humeral fractures – A systematic review

et al. 2021

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Background Distal humeral hemiarthroplasty has been performed for a variety of indications with the most common being management of distal humeral fractures. This systematic review evaluates the outcomes and complications of distal humeral hemiarthroplasty for this pathology. Methods We searched PubMed, EMBASE, and MEDLINE for studies reporting indications and outcomes of patients undergoing distal humeral hemiarthroplasty. Study screening, risk of bias assessment, and data extraction were performed. Summery statistics were provided. Results We included 11 studies ( N = 163) in this review. In all studies, the indication for distal humeral hemiarthroplasty was the presence of an intraarticular, comminuted, unreconstructable fracture. The mean post-operative MEPS, FullDASH, and QuickDASH (SD) scores were 83.6 (6.1) points, 25.4 (10.3), and 15.7 (7.4) points, respectively. The mean post-operative range of motion (SD) was 106° (11°) in the flexion and extension arc and 153° (19°) in the protonation and supination arc. The overall rate of adverse events and complication was 63%. The rate for major complications was 11%. The mean total revision rate was 4% (0% to 15) and total re-operation rate was 29% (0% to 88%). Conclusion Distal humeral hemiarthroplasty is a suitable option for unreconstructable distal humeral fractures and offers good functional outcomes with acceptable complication rates.

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“…The estimation of SD = 16 is extrapolated from a study on 24 patients with distal humeral fractures treated with EHA [1]. There is no MCID defined for the total score of OES, but Dawson et al have reported the MCID for each of the three domains-pain, function, and socialpsychological-for a group of patients with different pathologies including TEA for osteoarthritis and rheumatoid arthritis.…”

Section: Sample Size Calculation Oesmentioning

confidence: 99%

“…Unlinked TEA has been used to minimize the mechanical complications of the linked TEA, but the joint instability is a major complication, especially in condylar displacement, and the survival rate and functional results may be lower than for the linked arthroplasty [14,16,30,31]. Elbow hemiarthroplasty (EHA) provides a modern alternative that might avoid the mechanical complications and weight bearing restriction related to the linked articulation in TEA [1,19,20,24,26].…”

Section: Introductionmentioning

confidence: 99%

Elbow hemiarthroplasty versus open reduction and internal fixation for AO/OTA type 13 C2 and C3 fractures of distal humerus in patients aged 50 years or above: a randomized controlled trial

Al-Hamdani

Rasmussen

Holtz

et al. 2020

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Background: Intraarticular distal humeral fractures of AO/OTA type 13 C2 and C3 pose a surgical challenge despite the evolution of surgical implants and techniques. Open reduction and internal fixation (ORIF) is often preferred as the first choice of treatment, but the results vary and are sometimes disappointing. Total elbow arthroplasty (TEA) has been widely used for fractures that are not amenable to ORIF in elderly patients, but the mechanical complications remain a challenge, especially in active patients. Elbow hemiarthroplasty (EHA) provides a modern alternative that might avoid the mechanical complications and weight bearing restrictions related to the linked articulation in semi-constrained TEA. No studies have compared the results of EHA to that of ORIF, but case series have reported promising results. Methods/design: This is a study protocol describing an investigator-initiated, non-blinded randomized controlled trial comparing the outcome of EHA with ORIF for AO/OTA type 13 C2 and C3 fractures of the distal humerus in patients who are 50 years or older. Forty-four patients with AO/OTA type 13 C2 and C3 fractures of distal humerus will be randomized to either EHA or ORIF. The Oxford Elbow Score (OES) will be used as primary outcome. Mayo Elbow Performance Score (MEPS), pain severity score (VAS), range of motion, and patient satisfaction will be used as secondary outcomes. Reoperations, complications, and the length of sick leave will be recorded. The patients will be examined after the operation and at 3 months and 1, 2, 5, and 10 years. Discussion: The main objective of this study is to investigate the best treatment option for AO/OTA type 13 C2 and C3 fractures of distal humerus in patients aged 50 years or above. We hypothesize that EHA results in fewer complications and superior functional outcome compared with ORIF and that the mechanical complications related to the linked articulation of TEA can be avoided.

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Good outcome after elbow hemiarthroplasty in active patients with an acute intra-articular distal humeral fracture

Cited by 32 publications

References 18 publications

Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Outcomes and complications of distal humeral hemiarthroplasty for distal humeral fractures – A systematic review

Elbow hemiarthroplasty versus open reduction and internal fixation for AO/OTA type 13 C2 and C3 fractures of distal humerus in patients aged 50 years or above: a randomized controlled trial

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