Distal humerus hemiarthroplasty for trauma: a systematic review of the outcomes and complications
In patients with distal humerus fractures that are unreconstructible, total elbow arthroplasty is an established alternative to open reduction–internal fixation. Distal humerus hemiarthroplasty is a further alternative to avoid the significant lifestyle limitations associated with total elbow arthro...
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| Published in | Journal of shoulder and elbow surgery Vol. 31; no. 7; pp. 1545 - 1552 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
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United States
Elsevier Inc
01.07.2022
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| Abstract | In patients with distal humerus fractures that are unreconstructible, total elbow arthroplasty is an established alternative to open reduction–internal fixation. Distal humerus hemiarthroplasty is a further alternative to avoid the significant lifestyle limitations associated with total elbow arthroplasty. Distal humerus hemiarthroplasty is an increasingly popular treatment option for unreconstructible distal humeral fractures not amenable to reconstruction. The aim of this systematic review was to assess the literature regarding the functional outcomes and complications of the use of distal humerus hemiarthroplasty for acute trauma.
A systematic review of the PubMed, Embase, and Scopus databases was performed. The search terms included “distal humerus fracture” OR “elbow fracture” AND “hemiarthroplasty” OR “arthroplasty” OR “replacement.” Studies were limited to those published in the English language with reported functional outcome measures and complications. Patient demographic characteristics, implant systems, clinical outcomes (range of motion and functional outcome scores), and complications were extracted.
Thirteen studies with a total of 207 patients met the inclusion criteria. The average age ranged from 44 to 79 years, with the mean length of follow-up ranging from 11 to 82 months postoperatively. A mean range-of-motion arc ≥ 93° was achieved in all studies, with 11 of 13 studies achieving mean functional range of motion ≥ 100°. All studies reported good to excellent mean outcome scores. Heterotopic ossification, ulnar cartilage wear, stiffness, and ulnar neuropathy were the most commonly encountered complications. The reoperation rate and revision rate were 17% and 3%, respectively.
Distal humerus hemiarthroplasty is a viable option in the treatment of unreconstructible distal humerus fractures, with good to excellent outcomes expected. Long-term outcome data and the use of distal humerus hemiarthroplasty in younger patients are yet to be fully defined. |
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| AbstractList | In distal humerus fractures that are unreconstructable, Total Elbow Arthroplasty is an established alternative to Open Reduction Internal Fixation. Distal Humerus Hemiarthroplasty is a further alternative to avoid the significant lifestyle limitations associated with Total Elbow Arthroplasty. Distal humerus hemiarthroplasty is an increasingly popular treatment option for unreconstructable distal humeral fractures, not amenable to reconstruction. The aim of this systematic review is to assess the literature with regards the functional outcomes and complications of the use of Distal Humerus Hemiarthroplasty for acute trauma.
A systematic review of the databases of PubMed, EMBASE and SCOPUS was performed. Search terms included "distal humerus fracture" OR "elbow fracture", AND "hemiarthroplasty" OR "arthroplasty" OR "replacement". Studies were limited to those published in the English language and with reported functional outcome measures and complications. Patient demographics, implant system, clinical outcome (range of motion and functional outcome scores) and complications were extracted.
Thirteen studies with a total of 207 patients met the inclusion criteria. The average age ranged from 44 to 79 years with follow-up ranging from 11 to 82 months post op. A mean range of motion arc ≥ 93 degrees was achieved in all studies, with 11/13 studies achieving a mean functional range of motion ≥ 100 degrees. All studies reported good to excellent mean outcome scores. Heterotopic ossification, ulnar cartilage wear, stiffness and ulnar neuropathy were the most commonly encountered complications. The reoperation rate and revision rates were 17% and 3% respectively.
Distal Humerus Hemiarthroplasty is a viable option in the treatment of unreconstructable distal humerus fracture with good to excellent outcomes expected. Long term outcome data and its use in younger patients is yet to be fully defined. In patients with distal humerus fractures that are unreconstructible, total elbow arthroplasty is an established alternative to open reduction–internal fixation. Distal humerus hemiarthroplasty is a further alternative to avoid the significant lifestyle limitations associated with total elbow arthroplasty. Distal humerus hemiarthroplasty is an increasingly popular treatment option for unreconstructible distal humeral fractures not amenable to reconstruction. The aim of this systematic review was to assess the literature regarding the functional outcomes and complications of the use of distal humerus hemiarthroplasty for acute trauma. A systematic review of the PubMed, Embase, and Scopus databases was performed. The search terms included “distal humerus fracture” OR “elbow fracture” AND “hemiarthroplasty” OR “arthroplasty” OR “replacement.” Studies were limited to those published in the English language with reported functional outcome measures and complications. Patient demographic characteristics, implant systems, clinical outcomes (range of motion and functional outcome scores), and complications were extracted. Thirteen studies with a total of 207 patients met the inclusion criteria. The average age ranged from 44 to 79 years, with the mean length of follow-up ranging from 11 to 82 months postoperatively. A mean range-of-motion arc ≥ 93° was achieved in all studies, with 11 of 13 studies achieving mean functional range of motion ≥ 100°. All studies reported good to excellent mean outcome scores. Heterotopic ossification, ulnar cartilage wear, stiffness, and ulnar neuropathy were the most commonly encountered complications. The reoperation rate and revision rate were 17% and 3%, respectively. Distal humerus hemiarthroplasty is a viable option in the treatment of unreconstructible distal humerus fractures, with good to excellent outcomes expected. Long-term outcome data and the use of distal humerus hemiarthroplasty in younger patients are yet to be fully defined. BACKGROUNDIn patients with distal humerus fractures that are unreconstructible, total elbow arthroplasty is an established alternative to open reduction-internal fixation. Distal humerus hemiarthroplasty is a further alternative to avoid the significant lifestyle limitations associated with total elbow arthroplasty. Distal humerus hemiarthroplasty is an increasingly popular treatment option for unreconstructible distal humeral fractures not amenable to reconstruction. The aim of this systematic review was to assess the literature regarding the functional outcomes and complications of the use of distal humerus hemiarthroplasty for acute trauma. METHODSA systematic review of the PubMed, Embase, and Scopus databases was performed. The search terms included "distal humerus fracture" OR "elbow fracture" AND "hemiarthroplasty" OR "arthroplasty" OR "replacement." Studies were limited to those published in the English language with reported functional outcome measures and complications. Patient demographic characteristics, implant systems, clinical outcomes (range of motion and functional outcome scores), and complications were extracted. RESULTSThirteen studies with a total of 207 patients met the inclusion criteria. The average age ranged from 44 to 79 years, with the mean length of follow-up ranging from 11 to 82 months postoperatively. A mean range-of-motion arc ≥ 93° was achieved in all studies, with 11 of 13 studies achieving mean functional range of motion ≥ 100°. All studies reported good to excellent mean outcome scores. Heterotopic ossification, ulnar cartilage wear, stiffness, and ulnar neuropathy were the most commonly encountered complications. The reoperation rate and revision rate were 17% and 3%, respectively. CONCLUSIONSDistal humerus hemiarthroplasty is a viable option in the treatment of unreconstructible distal humerus fractures, with good to excellent outcomes expected. Long-term outcome data and the use of distal humerus hemiarthroplasty in younger patients are yet to be fully defined. |
| Author | Aresti, Nick A. Piggott, Robert P. Hennessy, Orla |
| Author_xml | – sequence: 1 givenname: Robert P. surname: Piggott fullname: Piggott, Robert P. email: Robpiggott1@gmail.com organization: St. James’s Hospital, Dublin, Ireland – sequence: 2 givenname: Orla orcidid: 0000-0002-4249-1974 surname: Hennessy fullname: Hennessy, Orla organization: Midlands Regional Hospital Tullamore, Tullamore, Ireland – sequence: 3 givenname: Nick A. orcidid: 0000-0003-4727-2970 surname: Aresti fullname: Aresti, Nick A. organization: Barts Bone and Joint Health, London, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35337953$$D View this record in MEDLINE/PubMed |
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| Keywords | Level IV Distal humerus hemiarthroplasty clinical outcomes Systematic Review elbow hemiarthroplasty elbow fracture distal humerus fractures Distal Humerus hemiarthroplasty Elbow hemiarthroplasty |
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| Snippet | In patients with distal humerus fractures that are unreconstructible, total elbow arthroplasty is an established alternative to open reduction–internal... In distal humerus fractures that are unreconstructable, Total Elbow Arthroplasty is an established alternative to Open Reduction Internal Fixation. Distal... BACKGROUNDIn patients with distal humerus fractures that are unreconstructible, total elbow arthroplasty is an established alternative to open... |
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| Title | Distal humerus hemiarthroplasty for trauma: a systematic review of the outcomes and complications |
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