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. 2022 Feb;14(1):85-94.
doi: 10.1177/1758573220977768. Epub 2020 Dec 15.

Does preservation of columns affect the medium-term outcome in distal humerus hemiarthroplasty for acute unreconstructable fractures?

Christopher W Jenkins  1 , Gray Ad Edwards  1 , Naomi Chalk  1 , Philip A McCann  1 , Rouin Amirfeyz  1
Affiliations

Does preservation of columns affect the medium-term outcome in distal humerus hemiarthroplasty for acute unreconstructable fractures?

Christopher W Jenkins et al. Shoulder Elbow. 2022 Feb.

Abstract

Background: We assessed distal humeral column preservation effects on clinical, radiographic and patient reported outcomes following distal humerus hemiarthroplasty for acute unreconstructable fractures.

Methods: Thirty-seven consecutive patients (mean age, 75; range, 29-93 years) with an average follow-up of 61 months (range, 24-105 months) after distal humerus hemiarthroplasty using a triceps preserving approach were studied. QuickDASH and Oxford Elbow Score assessed patient reported outcomes. Clinical and radiographic assessments comprised range of motion, grip strength, instability, implant loosening, chondral wear, heterotopic ossification and condylar union.

Results: Average QuickDASH was 14.9 (range, 0-63) and Oxford Elbow Score 40.35 (range, 25-48). Mean flexion arc was 108°, extension deficit 17° and pronosupination arc 155°. Average operative sided grip strength was 31.05 kg versus 31.13 kg contralaterally. Column preservation had no statistically significant effect on QuickDASH (p = 0.75), Oxford Elbow Score (p = 0.78), flexion-extension (p = 0.87), pronosupination (p = 0.78) or grip strength (p = 0.87). No progressive radiographic loosening or symptomatic chondral wear occurred. All fixed columns united. Three cases of immediate post-operative laxity fully resolved on elbow mobilisation. Four post-operative complications required further surgery: one ulnar neuropathy, one heterotopic ossification, one wound breakdown and one traumatic dislocation.

Conclusion: Medium-term outcome of distal humerus hemiarthroplasty for acute unreconstructable distal humeral fractures is reliable irrespective of condylar preservation.

Keywords: Distal humerus; arthroplasty; elbow; fracture; hemiarthroplasty.

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Conflict of interest statement

Declaration of Conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Trial reduction.
Figure 2.
Figure 2.
AP radiograph column fixation.
Figure 3.
Figure 3.
Lateral radiograph column fixation.
Figure 4.
Figure 4.
AP radiograph columns unfixable.
Figure 5.
Figure 5.
Lateral radiograph columns unfixable.
Figure 6.
Figure 6.
Closure.
Figure 7.
Figure 7.
Latitude DHH.
See this image and copyright information in PMC

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