Abstract

GALLUCCI, Gerardo et al. Artroplastia total de codo para el tratamiento de fracturas de húmero distal en pacientes mayores de 65 años. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2016, vol.81, n.2, pp.84-92. ISSN 1852-7434.

Objective: To report the clinical-functional results of humeral distal fracture treatment with total elbow prosthesis in patients older than 65 years. Methods: Retrospective study performed in two surgical centers. Inclusion criteria: patients with humeral distal fractures, >65 years, operated on with Coonrad-Morrey prostheses, and with a follow-up >1 year. Twenty-one patients were included (20 women) with an average age of 79 years. According to AO classification: 13 type C3 fractures, 7 C2 and 1 A2. All patients were operated on without disinsertion of the extensor mechanism. Average follow-up: 40 months. Results: Flexion-extension: 123-17°, with a total arc of mobility of 106° (80% of the contralateral side). Pain according to visual analogue scale was 1. The Mayo Clinic score was 83 points, results were excellent (8 patients), good (11 patients), regular (one case) and bad (one case). Average DASH score was 24 points. No loosening of the implants was evidenced in 13 patients. Nine complications were reported: 2 reoperations for polyethylene wear, one early decoupling of the prosthesis, 2 ulnar nerve paresthesia, one patient presented a false intraoperative via, one hematoma that needed a local flap and 2 loosening of the prosthesis. Conclusions: Treatment of humeral distal fractures with total elbow arthroplasty in patients older than 65 years may be a good therapeutic option, but indications must be limited to patients with complex fractures, bad bone quality, with osteoporosis and low functional demands.

Keywords : Distal humeral fracture; Supracondilar fracture; Total elbow arthroplasty; Older patients.

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