Epidemiology
The paper highlights the growing number of elderly osteopenic patients presenting with distal humeral fractures [PMID:22219241].
Clinical Presentation
The study included patients with complex presentations, such as those with rheumatoid arthritis, demonstrating the applicability of this surgical approach in special populations. [PMID:18178487]
Management
Under most circumstances, operative fixation and early mobilization is the treatment of choice, as it gives the best results [PMID:22219241].
The relative indications for and results of total elbow replacement versus internal fixation are discussed, indicating a nuanced approach based on patient-specific factors [PMID:22219241].
In a study of 18 patients with large coronal shear fractures treated with headless compression screws, all patients except one achieved good to excellent functional outcomes [PMID:19664940].
In a study involving 9 patients with distal humeral fractures, primary total elbow arthroplasty with the iBP unlinked prosthesis resulted in stable elbows, satisfactory pain relief, and functional outcomes as measured by the Mayo Elbow Performance Score (median 95). [PMID:18178487]
Complications
Radiographic follow-up revealed that 3 patients developed avascular necrosis and 5 developed arthrosis, though these complications did not significantly correlate with clinical outcomes [PMID:19664940].
Prognosis & Follow-up
The study reported a mean functional score of 93.3 on the Broberg-Morrey scale and an average arc of motion of 128 degrees in flexion/extension and 176 degrees in pronation/supination at a mean follow-up of 26 months [PMID:19664940].
The study reported that all patients were capable of performing daily activities with a median Mayo Elbow Performance Score of 95, indicating favorable long-term prognosis. [PMID:18178487]
References
1 Popovic D, King GJ. Fragility fractures of the distal humerus: What is the optimal treatment?. The Journal of bone and joint surgery. British volume 2012. link 2 Mighell M, Virani NA, Shannon R, Echols EL, Badman BL, Keating CJ. Large coronal shear fractures of the capitellum and trochlea treated with headless compression screws. Journal of shoulder and elbow surgery 2010. link 3 Kalogrianitis S, Sinopidis C, El Meligy M, Rawal A, Frostick SP. Unlinked elbow arthroplasty as primary treatment for fractures of the distal humerus. Journal of shoulder and elbow surgery 2008. link