Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.368
Revised: April 7, 2014
Accepted: April 16, 2014
Published online: July 18, 2014
AIM: To evaluate short- to medium term outcome of total elbow arthroplasty (TEA) in complex fractures of the distal humerus.
METHODS: A consecutive series of 24 complex distal humerus fractures operated with TEA in the period 2006-2012 was evaluated with the Mayo Elbow Performance score (MEPS), plain radiographs, complications and overall satisfaction. The indications for surgery were 1: AO type B3 or C3 or Sheffield type 3 fracture and age above 65 or 2: fracture and severe rheumatoid arthritis. Mean follow-up time was 21 mo.
RESULTS: Twenty patients were followed up. Four patients, of which 3 had died, were lost to follow up. According to the AO classification there were 17 C3, 1 B2 and 2 A2 fractures. Mean follow-up was 21 months (range 4-54). Mean MEPS was 94 (range 65-100). Mean flexion was 114 degrees (range 80-140). According to MEPS there were 15 excellent, 4 good and 1 fair result. Patient satisfaction: 8 excellent, 10 good, 2 fair and 1 poor. There were two revisions due to infection treated successfully with revision and three months of antibiotics. In two patients the locking split had loosened. One was referred to re-insertion and one chose yearly controls. Two patients had persistent dysaesthesia of their 5th finger, but were able to discriminate between sharp and blunt.
CONCLUSION: Our study suggests that TEA in complex fractures of the distal humerus in elderly patients can result in acceptable short- to medium term outcome.
Core tip: The number of distal humerus fractures in the elderly has increased in the last decades. The results after open reduction internal fixation in elderly with complex fractures of the distal humerus are highly variable with many failures and often poor outcome. We retrospectively reviewed a consecutive series of patients treated with total elbow arthroplasty (TEA) for complex fractures of the distal humerus. Our aim was to report short- to medium-term outcome. According to the Mayo Elbow Performance Score there were 15 patients with excellent results, 4 good, 1 fair and none poor. Our study suggests that TEA on fractures of the distal humerus in elderly patients can result in acceptable short- to medium-term outcome.