Unreconstructable acute distal humeral fractures and their sequelae treated with distal humeral hemiarthroplasty: a two-year to eleven-year follow-up

Background The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Methods Twenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied...

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Published inJournal of shoulder and elbow surgery Vol. 22; no. 12; pp. 1710 - 1723
Main Authors Smith, Geoffrey C.S., FRACS (Orth), Hughes, Jeffery S., FRACS (Orth)
Format Journal Article
LanguageEnglish
Published United States Mosby, Inc 01.12.2013
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Abstract Background The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Methods Twenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied retrospectively. Results Four patients had died and 4 had been revised to total elbow arthroplasty: 2 for periprosthetic fractures and 2 for primary component loosening (all in prostheses without an anterior flange). Six other complications had occurred: ulnar neuritis, 4; stiffness, 1; and wound necrosis, 1. Seventeen patients underwent assessment at a mean of 80 months after surgery. The mean values of the American Shoulder and Elbow Surgeons (ASES) elbow score (pain, 9.93; function, 25; satisfaction, 9.06); Mayo Elbow Performance Score (90); Quick Disabilities of Arm, Shoulder and Hand (19), and EuroQol EQ5D (Index, 0.84; Visual Analog Scale, 80) outcome measures demonstrated good function and satisfaction with little pain. The mean flexion extension arc was 116°. There was no evidence of instability. Radiologic evidence of ulnar wear was seen in 13 patients and may be related to prosthetic design to some extent. Worse wear was associated with a higher ASES pain score, lower satisfaction score, and lower EuroQoL Visual Analog Scale of quality of life. Degree of wear correlates with time after surgery but not with age at the time of surgery. Conclusion DHH offers a treatment option for unreconstructable distal humeral fractures and is associated with a good long-term outcome.
AbstractList Background The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Methods Twenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied retrospectively. Results Four patients had died and 4 had been revised to total elbow arthroplasty: 2 for periprosthetic fractures and 2 for primary component loosening (all in prostheses without an anterior flange). Six other complications had occurred: ulnar neuritis, 4; stiffness, 1; and wound necrosis, 1. Seventeen patients underwent assessment at a mean of 80 months after surgery. The mean values of the American Shoulder and Elbow Surgeons (ASES) elbow score (pain, 9.93; function, 25; satisfaction, 9.06); Mayo Elbow Performance Score (90); Quick Disabilities of Arm, Shoulder and Hand (19), and EuroQol EQ5D (Index, 0.84; Visual Analog Scale, 80) outcome measures demonstrated good function and satisfaction with little pain. The mean flexion extension arc was 116°. There was no evidence of instability. Radiologic evidence of ulnar wear was seen in 13 patients and may be related to prosthetic design to some extent. Worse wear was associated with a higher ASES pain score, lower satisfaction score, and lower EuroQoL Visual Analog Scale of quality of life. Degree of wear correlates with time after surgery but not with age at the time of surgery. Conclusion DHH offers a treatment option for unreconstructable distal humeral fractures and is associated with a good long-term outcome.
The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Twenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied retrospectively. Four patients had died and 4 had been revised to total elbow arthroplasty: 2 for periprosthetic fractures and 2 for primary component loosening (all in prostheses without an anterior flange). Six other complications had occurred: ulnar neuritis, 4; stiffness, 1; and wound necrosis, 1. Seventeen patients underwent assessment at a mean of 80 months after surgery. The mean values of the American Shoulder and Elbow Surgeons (ASES) elbow score (pain, 9.93; function, 25; satisfaction, 9.06); Mayo Elbow Performance Score (90); Quick Disabilities of Arm, Shoulder and Hand (19), and EuroQol EQ5D (Index, 0.84; Visual Analog Scale, 80) outcome measures demonstrated good function and satisfaction with little pain. The mean flexion extension arc was 116°. There was no evidence of instability. Radiologic evidence of ulnar wear was seen in 13 patients and may be related to prosthetic design to some extent. Worse wear was associated with a higher ASES pain score, lower satisfaction score, and lower EuroQoL Visual Analog Scale of quality of life. Degree of wear correlates with time after surgery but not with age at the time of surgery. DHH offers a treatment option for unreconstructable distal humeral fractures and is associated with a good long-term outcome. Level IV, case series, treatment study.
BACKGROUNDThe aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH).METHODSTwenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied retrospectively.RESULTSFour patients had died and 4 had been revised to total elbow arthroplasty: 2 for periprosthetic fractures and 2 for primary component loosening (all in prostheses without an anterior flange). Six other complications had occurred: ulnar neuritis, 4; stiffness, 1; and wound necrosis, 1. Seventeen patients underwent assessment at a mean of 80 months after surgery. The mean values of the American Shoulder and Elbow Surgeons (ASES) elbow score (pain, 9.93; function, 25; satisfaction, 9.06); Mayo Elbow Performance Score (90); Quick Disabilities of Arm, Shoulder and Hand (19), and EuroQol EQ5D (Index, 0.84; Visual Analog Scale, 80) outcome measures demonstrated good function and satisfaction with little pain. The mean flexion extension arc was 116°. There was no evidence of instability. Radiologic evidence of ulnar wear was seen in 13 patients and may be related to prosthetic design to some extent. Worse wear was associated with a higher ASES pain score, lower satisfaction score, and lower EuroQoL Visual Analog Scale of quality of life. Degree of wear correlates with time after surgery but not with age at the time of surgery.CONCLUSIONDHH offers a treatment option for unreconstructable distal humeral fractures and is associated with a good long-term outcome.LEVEL OF EVIDENCELevel IV, case series, treatment study.
The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Twenty-six patients (mean age, 62; range, 29-92 years) treated with DHH for intra-articular distal humeral fractures and its sequelae were studied retrospectively. Four patients had died and 4 had been revised to total elbow arthroplasty: 2 for periprosthetic fractures and 2 for primary component loosening (all in prostheses without an anterior flange). Six other complications had occurred: ulnar neuritis, 4; stiffness, 1; and wound necrosis, 1. Seventeen patients underwent assessment at a mean of 80 months after surgery. The mean values of the American Shoulder and Elbow Surgeons (ASES) elbow score (pain, 9.93; function, 25; satisfaction, 9.06); Mayo Elbow Performance Score (90); Quick Disabilities of Arm, Shoulder and Hand (19), and EuroQol EQ5D (Index, 0.84; Visual Analog Scale, 80) outcome measures demonstrated good function and satisfaction with little pain. The mean flexion extension arc was 116°. There was no evidence of instability. Radiologic evidence of ulnar wear was seen in 13 patients and may be related to prosthetic design to some extent. Worse wear was associated with a higher ASES pain score, lower satisfaction score, and lower EuroQoL Visual Analog Scale of quality of life. Degree of wear correlates with time after surgery but not with age at the time of surgery. DHH offers a treatment option for unreconstructable distal humeral fractures and is associated with a good long-term outcome.
Author Hughes, Jeffery S., FRACS (Orth)
Smith, Geoffrey C.S., FRACS (Orth)
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/24054974$$D View this record in MEDLINE/PubMed
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Issue 12
Keywords Treatment Study
Distal humerus
Level IV
Case Series
arthroplasty
hemiarthroplasty
fracture
Language English
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Snippet Background The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Methods...
The aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty (DHH). Twenty-six patients (mean...
BACKGROUNDThe aim of this study was to describe for the first time the medium to long-term outcome after distal humeral hemiarthroplasty...
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SubjectTerms Adult
Aged
Aged, 80 and over
Algorithms
arthroplasty
Distal humerus
Elbow Joint - injuries
Elbow Joint - surgery
Female
Follow-Up Studies
fracture
hemiarthroplasty
Hemiarthroplasty - adverse effects
Humans
Humeral Fractures - complications
Humeral Fractures - surgery
Humerus - injuries
Humerus - surgery
Intra-Articular Fractures - complications
Intra-Articular Fractures - surgery
Male
Middle Aged
Orthopedics
Osteotomy
Range of Motion, Articular
Retrospective Studies
Treatment Outcome
Title Unreconstructable acute distal humeral fractures and their sequelae treated with distal humeral hemiarthroplasty: a two-year to eleven-year follow-up
URI https://www.clinicalkey.es/playcontent/1-s2.0-S1058274613002899
https://dx.doi.org/10.1016/j.jse.2013.06.012
https://www.ncbi.nlm.nih.gov/pubmed/24054974
https://search.proquest.com/docview/1459973877
Volume 22
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