Total elbow arthroplasty for the treatment of distal humeral fractures.

Abstract Objective To report the clinical–functional outcomes of the treatment of humeral distal fractures with a total elbow prosthesis. Material and methods This retrospective study was performed in two surgical centres. A total of 23 patients were included, with a mean age of 79 years, and of which 21 were women. The inclusion criteria were: patients with humeral distal fractures, operated on using a Coonrad–Morrey prosthesis, and with a follow-up of more than one year. According to AO classification, 15 fractures were type C3, 7 C2 and 1 A2. All patients were operated on without de-insertion of the extensor mechanism. The mean follow-up was 40 months. Results Flexor-extension was 123–17°, with a total mobility arc of 106° (80% of the contralateral side). Pain, according to a visual analogue scale was 1. The Mayo elbow performance index (MEPI) was 83 points. Excellent results were obtained in 8 patients, good in 13, medium in 1, and poor in 1. The mean DASH (disability) score was 24 points. Conclusion Treatment of humeral distal fractures with total elbow arthroplasty could be a good treatment option, but indications must be limited to patients with complex fractures, poor bone quality, with osteoporosis and low functional demands. In younger patients, the use is limited to serious cases where there is no other treatment option. Level of Evidence Level of Evidence IV.