Primary semi-constrained arthroplasty for chronic fracture-dislocations of the elbow.
We present six patients with chronic dislocation of the elbow who were treated by primary semiconstrained total elbow arthroplasty. All were women with a mean age of 65 years (51 to 76), the mean interval between dislocation and surgery was 17 weeks (5 to 52) and the mean follow-up 58 months (24 to 123). The most dramatic improvement was in function. The mean American Shoulder and Elbow Surgeon score was 5.2 times better (p < 0.001) and the mean total range of movement increased from 33 degrees to 121 degrees (p < 0.001) after operation. Three patients developed wear of polyethylene. One required revision for a periprosthetic fracture, and another required a bushing exchange. Primary semiconstrained elbow arthroplasty provides significant, predictable functional improvement. Potential solutions for wear of polyethylene include a different operative technique or design of implant. Despite the high incidence of such wear, total elbow arthroplasty should be considered as a viable treatment option for chronic dislocation of the elbow in elderly patients.
Mighell
M A
MA
The Florida Orthopaedic Institute, Temple Terrace, Florida 33637, USA. mmighell@floridaortho.com
Dunham
R C
RC
Rommel
E A
EA
Frankle
M A
MA
D000368:Aged; D001134:Arm Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods*; D002908:Chronic Disease; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D020959:Polyethylene; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries
D020959:Polyethylene