Total elbow arthroplasty for acute distal humeral fractures in patients over 65 years old – Results of a multicenter study in 87 patients

Mansat, Pierre; Degorce, H. Nouaille; Bonnevialle, Nicolas; Demezon, Hugues; Fabre, Thierry; Sofcot,

doi:10.1016/j.otsr.2013.08.003

Cited by 72 publications

(54 citation statements)

References 23 publications

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“…The multicentric study of Mansat et al [11] (n=87) showed that primary TEA after distal humerus fractures provides satisfactory functional results as well as a painless and stable elbow. After a follow-up of 37.5 months a mean extension-flexion of 97°±22°with 48 % above 100°w as reached.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in the elderly a low-density bone structure is expected with an increasing risk of osteosynthesis failure [10]. Total elbow arthroplasty (TEA) is an alternative treatment, which provides immediate satisfactory results with pain relief, a stable and functional elbow and a low complication rate [11,12]. However the postoperative weight-bearing is lifelong limited to a maximum of 5 kg and the survival rate is critically discussed [13].…”

Section: Introductionmentioning

confidence: 99%

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Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus

Ellwein

Lill

Voigt

et al. 2014

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate and compare the results after double locking plate osteosynthesis (ORIF) and total elbow arthroplasty (TEA) in AO type C fractures of the distal humerus. Methods This retrospective study includes clinical results of 29 patients (9xTEA, 20xORIF) with a mean age of 62 years. The male to female ratio was 8:21. Range of motion, MEPS, DASH and complications were evaluated. Patients older than 60 years (n=19) were filtered and compared statistically.Results After a mean follow-up of 25 months the ORIF-group reached an extension-flexion of 99°±23°and the TEA-group of 111°±13°. The ORIF-group vs. the TEA-group had a mean MEPS of 85±17 vs. 94±11 and DASH of 34±24 vs. 24±12. In patients older than 60 years extension-flexion was 97°±23°a fter ORIF and 110°±14 after TEA (p=0.237). The ORIFgroup vs. the TEA-group had a mean MEPS of 82±21 vs. 94 ±11 (p=0.078) and DASH of 45±18 vs. 26±11 (p=0.023). The ORIF-group had a 4.4 times higher risk for major complications.Conclusion TEA and ORIF lead to comparable functional results, but major complications are more common after ORIF. Despite this, ORIF remains the gold standard for younger and older patients because of the lifelong loading limitation after TEA, unknown implant survival and problematic revision surgery. For patients older than 60 years a primary TEA can be recommended in exceptional cases, if the loading limitation is acceptable for the individual or the fracture is not reconstructable.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus

Ellwein

Lill

Voigt

et al. 2014

International Orthopaedics (SICOT)

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“…The main goal of distal humeral fracture treatment is anatomic reconstruction with preservation of the elbow joint. Total elbow arthroplasty represents an alternative treatment option providing immediate pain relief with a stable and functional elbow [6,7]. The functional results after TEA are mostly good to excellent [6,[8][9][10][11][12][13][14][15][16], but weight-bearing is limited to a maximum of 5 kg lifelong, and the longterm implant survival is as yet unknown [17].…”

Section: Introductionmentioning

confidence: 99%

Primary vs. secondary total elbow arthroplasty for distal humerus fractures

et al. 2019

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“…Total elbow arthroplasty (TEA) has been indicated for numerous degenerative inflammatory and traumatic elbow diseases [1][2][3][4]. Semiconstrained designs are usually used, allowing a certain degree of valgus/varus of the ulnar component in the hinge mechanism.…”

Section: Introductionmentioning

confidence: 99%

Mechanical failure of the Coonrad-Morrey linked total elbow arthroplasty: A case report

Pham

Bonnevialle

Rongières

et al. 2014

Orthopaedics & Traumatology: Surgery & Research

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a b s t r a c tSemiconstrained (linked design) total elbow arthroplasty is indicated in a wide variety of cases. Long-term survival is better than with non-linked prostheses. However, mechanical failure of the hinge mechanism is a complication that may occur during follow-up. We report a case of failure of the axle assembly of a Coonrad-Morrey elbow prosthesis 8 years after implantation for nonunion of a supracondylar distal humerus fracture. Initial revision surgery included changing the axle and the polyethylene bushings. Revision surgery was necessary 1 year later when the axle failed again. A custom-designed locking axle had to be used to stabilize the hinge mechanism. After 3 years follow-up, the hinge was intact, there was no loosening of the components and function of the elbow was good.

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Total elbow arthroplasty for acute distal humeral fractures in patients over 65 years old – Results of a multicenter study in 87 patients

Abstract: Level IV.

Cited by 72 publications

References 23 publications

Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus

Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus

Primary vs. secondary total elbow arthroplasty for distal humerus fractures

Mechanical failure of the Coonrad-Morrey linked total elbow arthroplasty: A case report

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