title: [Treatment of distal comminuted humeral fracture with serious osteoporosis by total elbow arthroplasty].
abstract: OBJECTIVE
  To analyse short-term clinical effect of total elbow arthroplasty in treatment of distal comminuted humeral fracture with serious osteoporosis in geratic patients.
  
  
  METHODS
  From April 2006 to October 2007, five cases of distal comminuted humeral fractures were treated by total elbow arthroplasty with bone cement. Of them, there were 2 males and 3 females, aging 50-76 years old (mean 67.6 years old), including 4 cases of closed fracture and 1 case of open fracture (II type Gustilo-Anderson). All fractures were caused by tumbling. According to classification of AO, there were 2 cases of type C1, 2 cases of type C2 and 1 case of type C3. The Barnett index of osteoporosis was 0.40-0.45. The time from injury to operation was 4 to 18 days (mean 7.2 days). The rehabilitation exercise of function was done after 2 days of operation.
  
  
  RESULTS
  The operative time was from 120 to 180 minutes (mean 150 minutes), the bleeding amount was from 150 to 250 mL (mean 200 mL). All incision achieved primary healing. No complication occurred. Five cases were followed up for 19 to 36 months (mean 24.5 months). The mean motion range of elbow joint include 141.6 degrees for flection, 6.5 degrees for extention, 10.2 degrees for the degree of ectropion, 81.7 degrees for revolve forward, and 73.8 degrees for revolve behind respectively after 4 months of operation. The length discrepancy of upper limb was less than 1.5 cm, the muscle force for flexion and extention of finger and wrist was normal. The X-ray films showed that the position of artificial joint was satisfactory without prosthesis dislocation or loosening. According to Mayo elbow performance score, the excellent and good rate was 80% (excellent in 1 case, good in 3 cases, and fair in 1 case).
  
  
  CONCLUSIONS
  Total elbow arthroplasty with bone cement is an effective method in treatment of distal comminuted humeral fracture with serious osteoporosis obviously in the geratic patients, but indication and technique of operation should be mastered strictly.
authors.affiliation: Department of Orthopaedics, Third Center Hospital, Tianjin, 300170, PR China. yqw1233068@sina.com
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Yin
authors.forename: Yi
authors.initials: Y
authors.lastname: Jiang
authors.forename: Liaxin
authors.initials: L
authors.lastname: Fu
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Li
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Tian
authors.forename: Liqiang
authors.initials: L
authors.lastname: Han
authors.forename: Lianping
authors.initials: L
authors.lastname: Xiao
authors.forename: Jinxin
authors.initials: J
authors.lastname: Zheng
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods; D005260:Female; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000150:complications / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000601:surgery*