6533b82efe1ef96bd12930e5

RESEARCH PRODUCT

Primäre Ellenbogenprothese bei distalen Humerustrümmerfrakturen

subject

description

The use of hip- and shoulder arthroplasty in elderly patients for grossly displaced intraarticular fractures is being more and more accepted. Total elbow replacement (TER) has not been considered as an option for the treatment of extensively comminuted fractures of the distal humerus because surgeons feel the outcome is not predictable after TER generally. On the basis of a Medline literature research of this issue and the documented results based on the improvement of the designs of the implants, operative technique and the selection of patients, TER has a definite role in the treatment of some fractures of the distal humerus. 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 (average duration of follow-up seven years). According to the AO classification, five fractures were type A, five were type B, and thirty-three were type C. The average flexion arc was 24 degrees to 131 degrees and the Mayo elbow performance score averaged 93 points. Thirty-two 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. Ten additional procedures, including five revision arthroplasties, were required in nine elbows. 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, when strict inclusion criteria are observed.