Treatment of distal humerus nonunions may be challenging, especially in the elderly patient. Total elbow replacement has been proposed as an option in selected patients, but a high index of complications has been reported. We present the results of a linked elbow replacement in six patients older than 70 years with a symptomatic nonunion of the distal humerus. At a mean follow-up of 40 months, average range of motion was from 15 degrees to 125 degrees of flexion-extension. Only one patient had moderate pain in the elbow, but all six were satisfied with the results of the operation. The arthroplasty allowed all patients to do basic tasks of daily living activities. Our results are encouraging, and show that linked elbow replacement is a good option in elderly patients with symptomatic nonunions of the distal humerus. Appropriate selection of ideal candidates for this procedure is a key factor in reducing the risk of complications.
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