Unreconstructable acute distal humeral fractures and their sequelae treated with distal humeral hemiarthroplasty: a two-year to eleven-year follow-up.

Background: The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH).

Methods: Twenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied retrospectively.

Results: Four patients had died and 4 had been revised to total elbow arthroplasty: 2 for periprosthetic fractures and 2 for primary component loosening (all in prostheses without an anterior flange).

Pictorial review: 'fishtail deformity' of the elbow.

Fishtail deformity of the elbow is characterised by a contour abnormality of the distal humerus, which develops when the lateral trochlear ossification centres fails to develop or resorbs. It is an uncommon complication usually following a distal humeral fracture in childhood. Whilst initially presumed to be a benign condition, long-term follow-up suggests that patients with fishtail deformity are prone to functional impairment, ongoing pain and the development of early osteoarthrosis.

Locked intramedullary nailing for treatment of displaced proximal humerus fractures.

Controversy surrounds the optimal technique for fixation of displaced fractures, although locked intramedullary nailing is emerging as a preferred technique in managing displaced proximal humerus fractures in appropriately selected patients. This technique provides stable fracture fixation allowing early postoperative mobilization critical in ensuring a pain-free shoulder with a functional range of motion. Additional advantages include the ability to insert by way of a minimally invasive approach with limited soft tissue dissection, achieve accurate anatomic reduction, provide a secure construct even in the situation of osteopenic bone or comminution, and manage fractures of the proximal humerus extending into the shaft.

Internal fixation of symptomatic os acromiale: a series of twenty-six cases.

Twenty-six patients who presented to our shoulder service with a symptomatic meso-os acromiale were reviewed. All had been initially treated for impingement symptoms. Nonoperative treatment had failed in all patients.