Total elbow arthroplasty for distal humeral fractures: indications, surgical approach, technical tips, and outcome.

Background: Twenty-six consecutive total elbow arthroplasties were performed for comminuted distal humeral fractures between 1995 and 2002. At review, 3 patients had died from unrelated causes, 2 had been lost to follow-up, and 1 could not be assessed due to dementia. The mean age of the remaining 20 patients was 72 years (range, 62-92). There were 4 men and 16 women.

Method: The mean follow-up was 63.2 months (range, 36-108). The mean Mayo Elbow Performance Score was 92 (75-100) with a mean flexion arc of 27 degrees - 125 degrees .

Result: One patient had a postoperative superficial infection, which required a course of antibiotic therapy, and 1 patient who had a radial nerve neuropraxia recovered spontaneously after 6 weeks. Radiographs showed 19 implants were well fixed with no evidence of loosening, while 1 patient had a nonprogressive radio-lucent line on the ulna side of the prosthesis. Additionally, 2 patients developed heterotopic ossification without identifying pre-disposing factors.

Conclusion: Total elbow arthroplasty for distal humeral fractures in elderly patients without inflammatory arthritis can be expected to five good results at a mean follow-up of 5 years.