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Published in: HAND 4/2014

01-12-2014 | Review

Distal humeral hemiarthroplasty: indications, results, and complications. A systematic review

Authors: John Dunn, Nicholas Kusnezov, Miguel Pirela-Cruz

Published in: HAND | Issue 4/2014

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Abstract

Background

Distal humeral hemiarthroplasty (DHH) is a treatment option for unreconstructable intra-articular distal humerus fractures. DHH may also be used in the setting of rheumatoid arthritis, orthopaedic tumor with significant bone loss, malunion, or osteomyelitis. DHH has specific advantages over other, more common, treatment modalities: total elbow arthroplasty (TEA) and open reduction internal fixation (ORIF). DHH is especially a reasonable option in younger patients to preserve bone stock, avoid significant weight restrictions, and limit loosening.

Methods

The literature was reviewed for all cases of DHH for fracture and non-fracture indications between 1947 and 2014. Two hundred thirty-six papers were identified; 4 studies including 17 patients met criteria for non-fracture indications and 13 studies including 116 patients were identified for fracture indications. A systematic review was generated; patient indications, outcomes, and complications were recorded.

Results

For non-fracture indications, good to excellent results were achieved in 76.5 % of patients with a mean arc of motion of 62° at mean follow up of 46.3 months. Half of the patients experienced a complication, most commonly stiffness. Loosening of the prosthesis was not noted in any patient. For fractures, good to excellent results were achieved in 67.4 % of patients with a mean arc of motion of 98.3° at a mean follow up of 42.2 months. One third of the patients experienced a complication but only 1.7 % experienced loosening of the prosthesis.

Conclusion

Here, we present the first review of the indications for DHH. DHH is a reasonable treatment option for older patients with unreconstructable intra-articular fractures of the distal humerus as well as younger patients with rheumatoid arthritis, orthopaedic tumor with significant bone loss, malunion, or osteomyelitis.
Literature
1.
Adolfsson L, Hammer R. Elbow hemiarthroplasty for acute reconstruction of intraarticular distal humerus fractures. Acta Orthop. 2006;77:785–7.PubMedCrossRef
2.
Argintar E, Berry M, Narvy SJ, Kramer J, Omid R, Itamura JM. Hemiarthroplasty for the treatment of distal humerus fractures: short-term clinical results. Orthopedics. 2012;35:1042–5.PubMedCrossRef
3.
Barnea Y, Amir A, Shlomo D, Cohen N, Zaretski A, Leshem D, et al. Free fibular flap elbow-joint hemiarthroplasty reconstruction for chronic osteomyelitis of the distal humerus. J Reconstr Microsurg. 2006;22:167–71.PubMedCrossRef
4.
Barr J, Eaton R. Elbow reconstruction with a new prosthesis to replace the distal end of the humerus. J Bone Joint Surg. 1965;47(7):1408–13.PubMed
5.
Burkhart KJ, Nijs S, Mattyasovszky SG, Wouters R, Gruszka D, Nowak TE, et al. Distal humerus hemiarthroplasty of the elbow for comminuted distal humeral fractures in the elderly patient. J Trauma. 2011;71:635–42.PubMedCrossRef
6.
Chalidis B, Dimitriou C, Papdopoulos P, Petsatodis G, Giannoudis PV. Total elbow arthroplasty for the treatment of insufficient distal humeral fractures. A retrospective clinical study and review of the literature. Inj. 2009;40:582–90.CrossRef
7.
Cheung EV, O’Driscoll SW. Total elbow prosthesis loosening caused by ulnar component pistoning. J Bone Joint Surg. 2007;89:1269–74.PubMed
8.
Chung K, Burns P, Kim M. A practical guide to meta-analysis. J Hand Surg. 2006;31(10):1671–8.CrossRef
9.
Figgie MP, Su EP, Kahn B. Locking mechanism failure in semiconstrained total elbow arthroplasty. J Shoulder Elbow Surg. 2006;15:88–93.PubMedCrossRef
10.
Frankle MA, Herscovici D, DiPasquale T, Vasey M, Sanders R. A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than 65. J Orthop Trauma. 2003;17(7):473–80
11.
Goldberg SH, Urban RM, Jacobs JJ. Modes of wear after semiconstrained total elbow arthroplasty. J Bone Joint Surg Am. 2008;90:609–19.PubMedCrossRef
12.
Hausman M, Panozzo A. Treatment of distal humerus fractures in the elderly. Clin Orthop Relat Res. 2004;425:55–63.PubMedCrossRef
13.
Hohman DW, Nodzo SR, Qvick LM, Duquin TR, Paterson PP. Hemiarthroplasty of the distal humerus for acute and chronic complex intra-articular injuries. J Shoulder Elbow Surg. 2014;23:265–72.PubMedCrossRef
14.
John H, Rosso R, Neff U, Bodoky A, Regazzoni P, Harder F. Operative treatment of distal humeral fractures in the elderly. J Bone Joint Surg (Br). 1994;76:793–6.
15.
Jupiter J, Morrey BF. The Elbow and Its Disorders, ed 3. Philadelphia: PA, WB Saunders; 2000. p. 293–330.
16.
Kamineni S, Morrey BF. Distal humeral fractures treated with noncustom total elbow replacement. J Bone Joint Surg Am. 2004;86(5):940–7.PubMed
17.
Korner J, Lill H, Muller LP, et al. Results after open reduction and internal fixation. Osteoporos Int. 2005;16:S73–9.PubMedCrossRef
18.
19.
Lapner M, King GJ. Elbow arthroplasty for distal humeral fractures. Instr Course Lect. 2014;63:15–26.PubMed
20.
Little C, Graham A, Carr A. Total elbow arthroplasty. A systematic review of the literature in the English language until the end of 2003. J Bone Joint Surg (Br). 2005;87B(4):437–43.CrossRef
21.
Mansat P, Bonnevialle N, Rongieres M, Mansat M, Bonnevialle P. Experience with Coonrad-Morrey total elbow arthroplasty: 78 consecutive total elbow arthroplasties reviewed with an average 5 years follow up. J Shoulder Elbow Surg. 2013;22(11):1461–8.PubMedCrossRef
22.
Mansat P, Degorce N, Bonnevialle N, Demezon H, Fabre T. Total elbow arthroplasty for acute distal humeral fractures in patients over 65 years old—results of a multicenter study in 87 patients. Orthop Traumatol: Surg Res. 2013;99:779–84.
23.
Mellen R, Phalen G. Arthroplasty of the elbow by replacement of the dial portion of the humerus with an acrylic prosthesis. J Bone Joint Surg. 1947;29(2):348–53.PubMed
24.
Morrey BF, Adams RA, Bryan RS. Total replacement for post-traumatic arthritis of the elbow. J Bone Joint Surg (Br). 1991;73(4):607–12.
25.
Parsons M, O’Brien R, Hughes J. Elbow hemiarthroplasty for acute and salvage reconstruction of intra-articular distal humerus fractures. Tech Hand Upper Extrem Surg. 2005;6:87–97.
26.
Scaglioni MF, Change EI, Gur E, Barnea Y, Meller I, Kollander Y, et al. The role of the fibula head flap for joint reconstruction after osteoarticular resections. J Plast Reconstr Aesthet Surg. 2014;67:617–23.PubMedCrossRef
27.
Schneedberger AG, Meyer DM, YHian EH. Coonrad-Morrey total elbow replacement for primary and revision surgery: a 2 to 7.5 year follow up study. J Shoulder Elbow Surg. 2007;16:25–54S.CrossRef
28.
Shifrin P, Johnson D. Elbow hemiarthroplasty with 20-year follow-up study. Clin Orthop Relat Res. 1990;254:128–33.PubMed
29.
Smith GC, Hughes JS. Unreconstructable acute distal humeral fractures and their sequelae treated with distal humeral hemiarthroplasty: a two-year to eleven-year follow up. J Shoulder Elbow Surg. 2013;22:1710–23.PubMedCrossRef
30.
Street DM, Stevens PS. A humeral replacement prosthesis for the elbow: results in ten elbows. J Bone Joint Surg Am. 1974;56:1147–58.PubMed
31.
Swoboda B, Scott RD. Humeral hemiarthroplasty of the elbow joint in young patients with rheumatoid arthritis: a report on 7 arthroplasties. J Arthroplasty. 1999;14:553–9.PubMedCrossRef
32.
Wang Y, Zhuo Q, Tang P, Yang W. Surgical interventions for treating distal humeral fractures in adults. Cochrane Database Syst Rev. 2013;1, CD009890.PubMed
Metadata
Title
Distal humeral hemiarthroplasty: indications, results, and complications. A systematic review
Authors
John Dunn
Nicholas Kusnezov
Miguel Pirela-Cruz
Publication date
01-12-2014
Publisher
Springer US
Published in
HAND / Issue 4/2014
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-014-9681-3

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