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J Shoulder Elbow Surg. 2014 Feb;23(2):265-72. doi: 10.1016/j.jse.2013.05.007. Epub 2013 Jun 18.

Hemiarthroplasty of the distal humerus for acute and chronic complex intra-articular injuries.

Author information

  • 1Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA. Electronic address: donaldhohman@gmail.com.
  • 2Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA.

Abstract

BACKGROUND:

Comminuted intra-articular distal humeral fractures represent a challenging upper extremity injury. This study reviews clinical and radiographic results in patients with distal humeral hemiarthroplasty (DHH).

METHODS:

DHH with the Latitude prosthesis (Tornier, Saint-Ismier, France) was performed in 8 patients (mean age, 64 years; age range, 33-75 years) for unreconstructible fractures of the distal humerus or salvage of failed internal fixation. Clinical outcomes were assessed with the American Shoulder and Elbow Surgeons elbow instrument; Mayo Elbow Performance Index; and Disabilities of the Arm, Shoulder and Hand questionnaire at a mean of 36 months. Radiologic assessment included radiographs and computed tomography to evaluate olecranon wear and densitometry (dual-energy x-ray absorptiometry). Range of motion, pain, and elbow satisfaction were recorded, and descriptive statistics were used for analysis.

RESULTS:

Seven patients were available to participate in the follow-up examination. Acute cases (5 patients) scored better than salvage cases (2 patients) on the Mayo Elbow Performance Score (80 points [range, 67-95 points] and 65 points [range, 50-80 points], respectively) and Disabilities of the Arm, Shoulder and Hand score (31 points [range, 2.5-68 points] and 39 points [range, 17-62 points], respectively). The mean arc of elbow flexion and extension was 96° (range, 70°-130°), with mean flexion of 120° (range, 90°-135°) and a mean extension loss of 19° (range, 5°-30°). The mean arc of forearm rotation was 160° (range, 140°-180°). Reoperation was required in 4 patients because of painful retained hardware. Five patients reported pain with activities of daily living.

CONCLUSION:

DHH should be used with caution until such time as longer-term outcome studies are able to show the efficacy of this procedure.

Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

KEYWORDS:

Case Series; Hemiarthroplasty; Level IV; Treatment Study; arthroplasty; clinical outcome; distal humerus; elbow; fracture

PMID:
23790327
[PubMed - indexed for MEDLINE]
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