Primary total elbow arthroplasty in complex fractures of the distal humerus

摘要

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 period2006-2012 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 C3,1B2 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 1poor.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 con-trols.Two patients had persistent dysaesthesia of their5th 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.