The clinical outcome and activity levels of patients under 55 years treated with distal humeral hemiarthroplasty for distal humeral fractures: minimum 2-year follow-up
Restricted accessResearch articleFirst published online October, 2016
The clinical outcome and activity levels of patients under 55 years treated with distal humeral hemiarthroplasty for distal humeral fractures: minimum 2-year follow-up
The aim of the present study was to describe the clinical outcomes and activity levels of young patients after distal humeral hemiarthroplasty (DHH).
Methods
Six patients under 55 years (mean 44 years; range 29 years to 52 years) treated with DHH at a mean postoperative time of 81 months (range 24 months to 133 months) were studied retrospectively. Two other patients had been revised for aseptic loosening and were excluded.
Results
The mean Mayo Elbow Score (MEPS) (88), Subjective Elbow Value (SEV) (89), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) (12) and American Shoulder and Elbow Surgeons (ASES) elbow pain (6), function (23) and satisfaction scores (9) were satisfactory. The mean University of California, Los Angeles (UCLA) activity score was 7.2.
Conclusions
Although only rarely indicated, DHH has satisfactory clinical outcomes in young patients and allows a higher level of function than is generally advised after total elbow arthroplasty.
AliAShahaneSStanleyD. Total elbow arthroplasty for distal humeral fractures: indications, surgical approach, technical tips, and outcome. J Shoulder Elbow Surg2010; 19(2 Suppl): 53–8.
7.
AntuñaSALaaksoRBBarreraJLEspigaXFerreresA. Linked total elbow arthroplasty as treatment of distal humerus fractures. Acta Orthop Belg2012; 78: 465–72.
8.
ArmstrongADYamaguchiK. Total elbow anthroplasty and distal humerus elbow fractures. Hand Clinics2004; 20: 475–83.
9.
ChalidisBDimitriouCPapadopoulosPPetsatodisGGiannoudisPV. Total elbow arthroplasty for the treatment of insufficient distal humeral fractures. A retrospective clinical study and review of the literature. Injury2009; 40: 582–90.
10.
CilA. Linked elbow replacement: a salvage procedure for distal humeral nonunion. J Bone Joint Surg Am2008; 90: 1939–1939.
11.
CobbTKMorreyBF. Total elbow arthroplasty as primary treatment for distal humeral fractures in elderly patients. J Bone Joint Surg Am1997; 79: 826–32.
12.
FrankleMAHerscoviciDJDiPasqualeTGVaseyMBSandersRW. A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65. J Orthop Trauma2003; 17: 473–80.
13.
GambirasioRRiandNSternRHoffmeyerP. Total elbow replacement for complex fractures of the distal humerus. An option for the elderly patient. J Bone Joint Surg Br2001; 83: 974–8.
14.
GarciaJAMykulaRStanleyD. Complex fractures of the distal humerus in the elderly. The role of total elbow replacement as primary treatment. J Bone Joint Surg Br2002; 84: 812–6.
15.
KalogrianitisSSinopidisCMeligy ElMRawalAFrostickSP. Unlinked elbow arthroplasty as primary treatment for fractures of the distal humerus. J Shoulder Elbow Surg2008; 17: 287–92.
16.
KamineniSMorreyBF. Distal humeral fractures treated with noncustom total elbow replacement. J Bone Joint Surg Am2004; 86A: 940–7.
17.
McKeeMDVeilletteCJHHallJA. A multicenter, prospective, randomized, controlled trial of open reduction – internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients. J Shoulder Elbow Surg2009; 18: 3–12.
ObremskeyWTBhandariMDirschlDRShemitschE. Internal fixation versus arthroplasty of comminuted fractures of the distal humerus. J Orthop Trauma2003; 17: 463–5.
20.
RayPSKakarlapudiKRajsekharCBhamraMS. Total elbow arthroplasty as primary treatment for distal humeral fractures in elderly patients. Injury2000; 31: 687–92.
21.
AdolfssonLHammerR. Elbow hemiarthroplasty for acute reconstruction of intraarticular distal humerus fractures: a preliminary report involving 4 patients. Acta Orthop2006; 77: 785–7.
22.
AdolfssonLNestorsonJ. The Kudo humeral component as primary hemiarthroplasty in distal humeral fractures. J Shoulder Elbow Surg2012; 21: 451–5.
23.
ArgintarEBerryMNarvySJKramerJOmidRItamuraJM. Hemiarthroplasty for the treatment of distal humerus fractures: short-term clinical results. Orthopedics2012; 35: 1042–5.
24.
BarrJSEatonRG. Elbow reconstruction with a new prosthesis to replace the distal end of the humerus. A case report. J Bone Joint Surg Am1965; 47: 1408–13.
25.
BurkhartKJNijsSMattyasovszkySG. Distal humerus hemiarthroplasty of the elbow for comminuted distal humeral fractures in the elderly patient. J Trauma2011; 71: 635–42.
26.
DunnJKusnezovNPirela-CruzM. Distal humeral hemiarthroplasty: indications, results, and complications. A systematic review. Hand2014; 9: 406–12.
27.
HohmanDWNodzoSRQvickLMDuquinTRPatersonPP. Hemiarthroplasty of the distal humerus for acute and chronic complex intra-articular injuries. J Shoulder Elbow Surg2014; 23: 265–72.
28.
HughesJUnlinked arthroplasty: distal humeral hemiarthroplasty. In: MorreyBFSanchez-SoteloJ (eds). The elbow and its disorders, 4th edition. Philadelphia, PA: WB Saunders Company, 2009.
HughesJParsonsMDistal humeral hemiarthroplasty. In: YamaguchiKO'DriscollSKIngGMcKeeM (eds). Advanced reconstruction elbow, Rosemont, IL: American Academy of Orthopaedic Surgeons, 2006, pp. 219–219.
31.
MellenRHPhalenGS. Arthroplasty of the elbow by replacement of the distal portion of the humerus with an acrylic prosthesis. J Bone Joint Surg Am1947; 29: 348–53.
32.
NestorsonJEkholmCEtznerMAdolfssonL. Hemiarthroplasty for irreparable distal humeral fractures: medium-term follow-up of 42 patients. Bone Joint J2015; 97B: 1377–84.
33.
ParsonsMO'BrienRJHughesJS. Elbow hemiarthroplasty for acute and salvage reconstruction of intra-articular distal humerus fractures. Tech Shoulder Elbow Surg2005; 6: 87–97.
34.
PhadnisJWattsACBainGI. Elbow hemiarthroplasty for the management of distal humeral fractures: current technique, indications and results. Shoulder and Elbow2016, pp. 171–83.
35.
ShifrinPGJohnsonDP. Elbow hemiarthroplasty with 20-year follow-up study: a case report and literature review. Clin Orthopaedics Rel Res1990; 254: 128–33.
36.
SmithGCSHughesJS. Unreconstructable acute distal humeral fractures and their sequelae treated with distal humeral hemiarthroplasty: a two-year to eleven-year follow-up. J Shoulder Elbow Surg2013; 22: 1710–23.
37.
SwobodaBScottRD. Humeral hemiarthroplasty of the elbow joint in young patients with rheumatoid arthritis: a report on 7 arthroplasties. J Arthroplasty1999; 14: 553–9.
38.
VenableCS. An elbow and an elbow prosthesis; case of complete loss of the lower third of the humerus. Am J Surg1952; 83: 271–5.
39.
BarlowJDMorreyBFO'DriscollSWSteinmannSPSanchez-SoteloJ. Activities after total elbow arthroplasty. J Shoulder Elbow Surg2013; 22: 787–91.
RanawatCSPadgettDEOhashiY. Total knee arthroplasty for patients younger than 55 years. Clin Orthop Relat Re1989; 248: 27–27.
42.
SternSHBowenMKInsallJNScuderiGR. Cemented total knee arthroplasty for gonarthrosis in patients 55 years old or younger. Clin Orthop Relat Res1990; 260: 124–124.
43.
AasheimTFinsenV. The DASH and the QuickDASH instruments. Normative values in the general population in Norway. J Hand Surg Br2014; 39: 140–4.
