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

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Author(s)
Du-Han KimBeom-Soo KimChung-Sin BaekChul-Hyun Cho
Publication Year
2020
Keyword
ElbowArthroplastyFractureComplicationsTotal joint replacementClinical outcome
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.
Alternative Title
Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up
Department
Dept. of Orthopedic Surgery (정형외과학)
Publisher
School of Medicine (의과대학)
Citation
대한견주관절학회지, Vol.23(1) : 20-26, 2020
Type
Article
ISSN
2288-8721
DOI
10.5397/cise.2020.00045
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42696
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