Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up

Abstract

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7º of flexion, 13.8º of extension, 73.3º of pronation, and 74.4º of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

Comparative Analysis of Clinical Effects of the Cable‐Pin System and Kirschner Wire Tension Band (TBW) Internal Fixation in the Treatment of the Olecranon Fracture

“…The sagittal position has the movement function of elbow flexion and extension, which is of great significance for maintaining the stability of the elbow [ 12 ]. In addition, since the ulnar olecranon is one of the important components of the elbow extension power device, the fracture in the olecranon also represents the fracture of the elbow extension device, and the patient often loses the function of active elbow extension [ 13 ]. The olecranon fracture is one of the common injuries of elbow, which is more common in adults, accounting for about 1.17% of systemic fractures [ 14 ].…”

“…The olecranon fracture is one of the common injuries of elbow, which is more common in adults, accounting for about 1.17% of systemic fractures [ 14 ]. With the continuous improvement of social material culture and living standards, the incidence of the olecranon fracture induced by a high energy compound injury is increasing year by year, except for a few olecranon tip avulsion fractures, most patients are intra-articular fractures involving the cartilage surface of the semilunar joint [ 13 ]. Owing to the interaction of extensor and flexor muscles of the elbow, the displacement of the fracture end is very prone to occur.…”

Implant survival of total elbow arthroplasty: analysis of 514 cases from the Dutch Arthroplasty Registry

“…The currently available follow-up data for total elbow implants are limited to relatively small cohort studies, except for one study including 461 elbows published by the designer of the implant. 3,[14][15][16][17][18][19][20][21] Cohort studies are potentially prone to bias and conflicts of interest. To circumvent these issues, data from a national registry can be used.…”