[Primary total elbow replacement for complex intra-articular distal humerus fractures].

Introduction: Open reduction and internal fixation of multifragmentary intra-articular fractures of the distal humerus often do not provide satisfactory results in elderly patients with osteoporosis.

Method: From December 2001 to January 2008 a total elbow arthroplasty (Coonrad-Morrey, Zimmer, USA) was performed on 12 patients (average age 81+/-9 ears) who presented with a type C distal humeral fracture. The mean time of follow-up with clinical and radiological assessment was 28+/-17 months.

Results: The Mayo score showed a good functional result with an average of 81+/-9 out of 100. DASH and SECEC scores showed a fair result with respect to elbow function (43+/-8 and 68+/-7 points, respectively). The average range of motion of all patients was 120-33-0 degrees. Heterotopic ossifications were found by X-ray examination in 4 cases and asymptomatic radiolucent lines in 4 cases.

Conclusion: Primary total elbow arthroplasty for complex intra-articular distal humerus fractures in elderly patients has good functional results and is an alternative to osteosynthesis.