The Journal of Bone and Joint Surgery (American). 2005;87:41-50.
doi:10.2106/JBJS.D.02871
© 2005 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kamineni, S.
Right arrow Articles by Morrey, B. F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kamineni, S.
Right arrow Articles by Morrey, B. F.
Related Collections
Right arrow Surgical Techniques
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Distal Humeral Fractures Treated with Noncustom Total Elbow Replacement

S. Kamineni, FRCS(Orth)1 and Bernard F. Morrey, MD2

1 Department of Orthopaedics and Biomechanics, Imperial College London and Hillingdon Hospital NHS Trust, South Kensington Campus, London SW7 2AZ, United Kingdom
2 Department of Orthopedic Surgery, 128 Guggenheim Building, Mayo Clinic, Mayo Building, 200 First Street S.W., Rochester, MN 55905

Investigation performed at the Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota

The original scientific article in which the surgical technique was presented was published in JBJS Vol. 86-A, pp. 940-947, May 2004

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commerical entity (royalty for implant). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The line drawings in this article are the work of Joanne Haderer Müller of Haderer & Müller (biomedart{at}haderermuller.com).

BACKGROUND:

The purpose of this study was to review the cases of patients with a distal humeral fracture that was treated with a noncustom total elbow arthroplasty. We hypothesized that, on the basis of the functional and clinical outcome, total elbow replacement is a reliable option for the treatment of elderly patients with a severe, comminuted fracture of the distal part of the humerus.

METHODS:

We retrospectively reviewed forty-nine acute distal humeral fractures in forty-eight patients who were treated with total elbow arthroplasty as the primary option. The average age of the patients was sixty-seven years. Forty-three fractures were followed for at least two years. According to the AO classification, five fractures were type A, five were type B, and thirty-three were type C. The average age of the forty-three patients was sixty-nine years and the average duration of follow-up was seven years. Fourteen patients died during the review period. Postoperative clinical function was assessed with use of the Mayo elbow performance score, and anteroposterior and lateral radiographs made at follow-up examinations were reviewed.

RESULTS:

At the latest follow-up examination, the average flexion arc was 24° (range, 0° to 75°) to 131° (range, 100° to 150°) and the Mayo elbow performance score averaged 93 of a possible 100 points. Heterotopic ossification was present to some extent in seven elbows, with radiographic abutment noted in two. Thirty-two (65%) of the forty-nine elbows had neither a complication nor any further surgery from the time of the index arthroplasty to the most recent follow-up evaluation. Fourteen elbows (29%) had a single complication, and most of them did not require further surgery. Ten additional procedures, including five revision arthroplasties, were required in nine elbows; five were related to soft tissue and five were related to the implant or bone.

CONCLUSIONS:

Complex distal humeral fractures should be assessed primarily for the reliability with which they can be reconstructed with osteosynthesis. When osteosynthesis is not considered to be feasible, especially in patients who are physiologically older and place lower demands on the joint, total elbow arthroplasty can be considered. This retrospective review supports a recommendation for total elbow arthroplasty for the treatment of an acute distal humeral fracture when strict inclusion criteria are observed.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
B. Jost, R. A. Adams, and B. F. Morrey
Management of Acute Distal Humeral Fractures in Patients with Rheumatoid Arthritis. A Case Series
J. Bone Joint Surg. Am., October 1, 2008; 90(10): 2197 - 2205.
[Abstract] [Full Text] [PDF]