TY - JOUR
T1 - Total elbow arthroplasty in distal humeral nonunion
T2 - Clinical and radiographic evaluation after a minimum follow-up of three years
AU - Pogliacomi, Francesco
AU - Aliani, Davide
AU - Cavaciocchi, Michele
AU - Corradi, Maurizio
AU - Ceccarelli, Francesco
AU - Rotini, Roberto
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Total elbow arthroplasties (TEAs) are usually indicated in chronic inflammatory arthropathies. This procedure has also recently been used in complex distal humeral fractures and nonunions in selected patients. This study analyzed the clinical and radiographic outcomes in patients treated for nonunions around the elbow region with a minimum follow-up of 3 years. Methods: Between May 2002 and June 2012, 20 patients affected with distal humeral nonunions were treated with TEA. All patients were assessed clinically using the Mayo Elbow Performance Score and radiographically to evaluate the positioning of the prosthetic components and signs of loosening. Statistical analyses were performed to investigate the presence of clinical and radiographic variables as predictive factors of poor functional outcomes. Results: The Mayo Elbow Performance Score of the affected arm improved significantly between the preoperative period and follow-up. Results were good or excellent in 90% of the patients even if a high rate of complications (30%) was encountered. The development of complications after surgery and stages II, III, and IV radiolucency, according to the Morrey criteria, were predictive factors of poor outcomes. Conclusions: According to the satisfactory results observed in this study, TEA could be indicated in selected patients aged older than 70 years with low functional demands and affected with distal humeral nonunions in which obtaining a stable fixation is difficult.
AB - Background: Total elbow arthroplasties (TEAs) are usually indicated in chronic inflammatory arthropathies. This procedure has also recently been used in complex distal humeral fractures and nonunions in selected patients. This study analyzed the clinical and radiographic outcomes in patients treated for nonunions around the elbow region with a minimum follow-up of 3 years. Methods: Between May 2002 and June 2012, 20 patients affected with distal humeral nonunions were treated with TEA. All patients were assessed clinically using the Mayo Elbow Performance Score and radiographically to evaluate the positioning of the prosthetic components and signs of loosening. Statistical analyses were performed to investigate the presence of clinical and radiographic variables as predictive factors of poor functional outcomes. Results: The Mayo Elbow Performance Score of the affected arm improved significantly between the preoperative period and follow-up. Results were good or excellent in 90% of the patients even if a high rate of complications (30%) was encountered. The development of complications after surgery and stages II, III, and IV radiolucency, according to the Morrey criteria, were predictive factors of poor outcomes. Conclusions: According to the satisfactory results observed in this study, TEA could be indicated in selected patients aged older than 70 years with low functional demands and affected with distal humeral nonunions in which obtaining a stable fixation is difficult.
KW - Arthroplasty
KW - Distal humerus
KW - Elbow
KW - Evaluation
KW - Nonunion
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84947433528&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947433528&partnerID=8YFLogxK
U2 - 10.1016/j.jse.2015.08.010
DO - 10.1016/j.jse.2015.08.010
M3 - Article
C2 - 26475638
AN - SCOPUS:84947433528
VL - 24
SP - 1998
EP - 2007
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
SN - 1058-2746
IS - 12
ER -