scholarly journals Total Elbow Arthroplasty Gives Good Functional Outcome in Distal Humerus Fracture with Pre-existing Chronic Elbow Dislocation

2018 ◽  
Vol 24 (1) ◽  
pp. 60-65
Author(s):  
Chan Hing Shing ◽  
Ho Sheung Tung
Keyword(s):  
Internal Fixation ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Total Elbow Arthroplasty ◽  
Humerus Fracture ◽  
Distal Humerus Fracture ◽  
Elbow Arthroplasty ◽  
Flexion Extension ◽  
Long Stem ◽  
Chronic Elbow Dislocation

Distal humerus fracture with concomitant chronic elbow dislocation is difficult to manage by open reduction and internal fixation, while total elbow arthroplasty (TEA) is an effective treatment for acute fracture or failed internal fixation of distal humerus fracture in elderly patients with osteoporosis. We present a case of an 86-year-old woman who suffered from acute distal humerus fracture in the presence of chronic elbow deformity from elbow dislocation since childhood at the age of 10 years. This was treated with TEA using Coonrad/Morrey prosthesis with long stem and long flange humerus components and cerclage wiring of humeral condyle. Postoperatively, elbow mobilization was started early within a hinged elbow brace. There was no operative complication. At the last follow-up 22 months after surgery, there was no pain and good elbow motion (20–130° flexion–extension arc, full supination and pronation to neutral) was obtained. The Mayo Elbow Performance Score was 100. There was incorporation of the bone graft at the anterior flange with no radiographic loosening of the prosthesis. This case shows that TEA can yield a gratifying clinical result and efficiently resolves two problems with one solution.

scholarly journals Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

2020 ◽  
Vol 23 (2) ◽  
pp. 94-99 ◽  
Author(s):  
Baik Jong Seok ◽  
Lee Sung Hyun ◽  
Hyun Tak Kang ◽  
Tae Hyun Song ◽  
Jeong Woo Kim
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Humerus ◽  
Humeral Fractures ◽  
Total Elbow Arthroplasty ◽  
Humerus Fracture ◽  
Dash Score ◽  
Distal Humerus Fracture ◽  
Elbow Arthroplasty ◽  
Distal Humeral Fractures

Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older.Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit.Results: The ORIF and TEA groups showed a mean arc of flexion–extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups.Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

scholarly journals Primary Linked Total Elbow Arthroplasty for Acute Distal Humerus Fracture Management: A Systematic Review of Clinical Outcome

2020 ◽  
Vol 12 (4) ◽  
pp. 503
Author(s):  
Erica Kholinne ◽  
Lamees Abdullah Altamimi ◽  
Aya Aldayel ◽  
Razan AlSabti ◽  
Hyojune Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcome ◽  
Distal Humerus ◽  
Total Elbow Arthroplasty ◽  
Humerus Fracture ◽  
Distal Humerus Fracture ◽  
Elbow Arthroplasty ◽  
Fracture Management

scholarly journals STUDY OF THE FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF INTRA-ARTICULAR DISTAL HUMERUS FRACTURE (AO/OTA TYPE C) IN ADULTS

2020 ◽  
pp. 1-3
Author(s):  
Ravindra Prasad ◽  
L B Manjhi
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Surgical Management ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Joint Surface ◽  
Distal Humerus Fracture ◽  
Complex Anatomy ◽  
Type C

Introduction: Distal humerus fracture in adults particularly complete articular (AO/OTA Type C) remain some of the most difficult injuries to manage. Complex anatomy of distal humerus combined with multifragmented fracture, sparse soft tissue cover with adjacent neurovascular structures poses great difficulty for treatment. Goal of treatment is to obtain a painless, stable and mobile elbow joint through a systematic approach. Aim: to study the functional outcome of surgical management of complete articular distal humerus fracture in adults. Method: a prospective study comprising of 20 patients treated surgically with open reduction and internal fixation using Orthogonal plating (dorsolateral and medial 3.5mm LCP) through trans olecranon approach. Result: Mean age of patients was 36.6 years (range 19 to 58 years) with male dominance, most fractures were of type 13C1 (AO/OTA). RTA accounts for most common mode of injury, majority of them being left sided. Mean operative time was 130 minutes. Complications included one case of superficial infection, 3 cases of ulnar neuropathy and non-union in 2 cases. Mean range of motion of elbow was 89 degree. Functional outcome assessed using Mayo Elbow Performance Score (MEPS) shown Excellent result in 12 cases, good to fair results in 6 and poor result in 2 cases. Conclusion: Anatomical restoration of joint surface and rigid internal fixation with bicolumnar orthogonal plating allowing early range of motion is the key for obtaining good functional results in complete articular distal humerus fractures. However, outcomes do deteriorate with increasing fracture complexity.

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