Distal Humeral Fractures Treated with Noncustom Total Elbow Replacement

The Role of Total Elbow Arthroplasty in Complex Distal Humeral Fractures

“…In 2004, Kamineni and Morrey [12], retrospectively reviewed 43 acute distal humeral fractures which had been treated with a Coonrad-Morrey TEA as the primary treatment.…”

“…Chronological age is not an absolute indication for TEA; instead the surgeon should consider patients who are physiologically older and who have lower activity levels. In addition, some younger patients with multiple co-morbidities who have sustained severe injuries resulting in destruction of the articular surfaces of the elbow, or in those where the architecture of the joint has been destroyed by rheumatoid arthritis, should be considered for TEA [7,12].…”

“…As a result, the majority of favorable results published to date, are based on the use of the Coonrad-Morrey TEA, which is a semiconstrained implant [8][9][10][11][12]. Through its ''sloppy hinge'' design, it permits sufficient axial rotation, and some valgus and varus laxity, to reduce stresses at the bone cement interface, aimed at reducing the incidence and speed of loosening.…”

Mid-term results of complex distal humeral fractures

“…In our series, outcomes worsened with age and a statistical significant difference was found between patients 65 years old or less and those above 65 years of age. For this reason, many authors [29][30][31][32][62][63][64][65] have successfully opted for total elbow arthroplasty for elderly patients presenting with complex fractures of the elbow which could not be appropriately treated with ORIF or with associated pre-existing degenerative or inflammatory diseases affecting the elbow. In our experience, only 3 patients, excluded from this study, had this primary treatment with the Coonrad-Morrey semi-constrained prosthesis.…”

“…These ranges of motion (ROM) were found to be sufficient to carry out a large part of a person's activity of daily living (ADL's) [28]. Total elbow replacement has been used, with good results, for elderly patients in which complex fractures could not be appropriately treated with ORIF or in cases where the elbow was affected by a pre-existing degenerative and inflammatory disease [29][30][31][32].…”