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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 3, 343-348.
doi: 10.1302/0301-620X.90B3.18971  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Outcome of total elbow replacement for distal humeral fractures in the elderly

A COMPARISON OF PRIMARY SURGERY AND SURGERY AFTER FAILED INTERNAL FIXATION OR CONSERVATIVE TREATMENT

N. Prasad, MRCSEd, MS, DNB, Registrar in Trauma & Orthopaedics1; and C. Dent, FCCS, FRCS(Trauma & Orth), MS, Professor2

1 Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, UK.
2 Llandough Hospital, Llandough, Cardiff CF64 2XX, UK.

Correspondence should be sent to Mr N. Prasad at 5 Lovage Close, Pontprennau, Cardiff CF23 8SB, UK; e-mail: nporth{at}yahoo.com

We analysed the outcome of the Coonrad-Morrey total elbow replacement used for fracture of the distal humerus in elderly patients with no evidence of inflammatory arthritis and compared the results for early versus delayed treatment. We studied a total of 32 patients with 15 in the early treatment group and 17 in the delayed treatment group. The mean follow-up was 56.1 months (18 to 88). The percentage of excellent to good results based on the Mayo elbow performance score was not significantly different, 84% in the early group and 79% in the delayed group. Subjective satisfaction was 92% in both the groups.

One patient in the early group developed chronic regional pain syndrome and another type 4 aseptic loosening. Two elbows in the early group also showed type 1 radiological loosening.

Two patients in the delayed group had an infection, two an ulnar nerve palsy, one developed heterotopic ossification and one type 4 aseptic loosening. Two elbows in this group also showed type 1 radiological loosening. The Kaplan-Meier survivorship analysis for the early and delayed treatment groups was 93% at 88 months and 76% at 84 months, respectively.

No significant difference was found between the two groups.




eLetters:

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Outcome of total elbow replacement for distal humeral fractures in the elderly
Michael D McKee
J Bone Joint Surg Br Online, 8 May 2008 [Full text]
Author's reply:
Narayana Prasad
J Bone Joint Surg Br Online, 23 May 2008 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General