• Injury · Oct 2024

    Total elbow arthroplasty and hemiarthroplasty in the treatment of distal humerus fractures in the elderly: Experience from a tertiary referral centre.

    • Sandeep Krishan Nayar, Foad Mohamed, Khayam Bashir, Amin Abukar, Aditya Prinja, and Abbas Rashid.
    • Whittington Health NHS Trust, United Kingdom; University College Hospitals NHS Foundation Trust, United Kingdom. Electronic address: sandeep.nayar@doctors.org.uk.
    • Injury. 2024 Oct 1; 55 (10): 111754111754.

    BackgroundThere is no clear consensus on whether total elbow arthroplasty (TEA) or hemiarthroplasty (HA) is superior for treating distal humerus fractures in the elderly. This study analysed the functional outcomes and re-operation rates following TEA and HA for intra-articular distal humerus fractures in patients aged ≥65 years.Methods19 patients (TEA = 12, HA = 7) treated between 2016 and 2022 were retrospectively reviewed. Mean age was 73 years and mean follow-up was 46 months. Functional outcomes and quality of life were assessed using the Mayo Elbow Performance Score (MEPS), Quick-DASH (Q-DASH), Oxford Elbow Score (OES), SF-12 Physical Component Score (PCS) and Mental Component Score (MCS), and EQ-5D. Complications requiring re-operation were recorded.ResultsHA showed superior outcomes in MEPS (93.6 vs 75.0, p = 0.0339), Q-DASH (13.3 vs 31.3, p = 0.0182), OES (41.7 vs 33.2, p = 0.0346), SF-12 PCS (55.5 vs 36.9, p = 0.0008) and EQ-5D (83 vs 67, p = 0.0023). One HA patient required revision to TEA for prosthetic joint infection. One TEA patient required revision for a periprosthetic ulna fracture.ConclusionHA provides better functional outcomes compared to TEA in the treatment of distal humerus fractures in the elderly. Data is limited by selection bias and low patient numbers with a multicentre randomised controlled trial warranted.Copyright © 2024 Elsevier Ltd. All rights reserved.

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