Total elbow arthroplasty following complex fractures of the distal humerus: results in patients over 65 years of age.
Keywords:
elbow, arthroplasty, prosthesis, trauma, fracture, distal humerusAbstract
Background: The treatment of complex distal humerus fractures is challenging and is often associated with unsatisfactory results. Anatomic reduction and stable internal fixation is difficult to obtain, especially in elderly osteoporotic patients. For these reasons, total elbow arthroplasty (TEA) has recently evolved as a valid procedure in selected cases following these injuries. The aim of this study was to analyze outcomes of TEA for the treatment of complex distal humerus fractures in 20 low-demanding patients over 65 years of age. Materials and methods: All patients, at a mean follow-up of 60 months, were evaluated clinically using the Mayo Elbow Performance Score (MEPS) and radiographically in order to assess the positioning of the prosthetic components and signs of loosening. Statistical analyses investigated the presence of clinical and radiographic variables as predictive factors of poor functional outcomes. Results: Similar MEPSs were observed in the affected and unaffected arm. Results were good or excellent in 90% of the patients, even if a high rate of complications (35%) was encountered. The development of postoperative complications and concomitant cognitive impairment and rheumatoid arthritis were predictive factors of unsatisfactory outcomes. Conclusions: According to the results observed, TEA can be considered as a valid treatment for complex fractures of the distal humerus in low-demanding patients older than 65 years of age, in which a stable fixation is difficult to obtain. Several variables may influence the final outcomes.
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.