title: Hemiarthroplasty of the distal humerus for acute and chronic complex intra-articular injuries.
abstract: BACKGROUND
  Comminuted intra-articular distal humeral fractures represent a challenging upper extremity injury. This study reviews clinical and radiographic results in patients with distal humeral hemiarthroplasty (DHH).
  
  
  METHODS
  DHH with the Latitude prosthesis (Tornier, Saint-Ismier, France) was performed in 8 patients (mean age, 64 years; age range, 33-75 years) for unreconstructible fractures of the distal humerus or salvage of failed internal fixation. Clinical outcomes were assessed with the American Shoulder and Elbow Surgeons elbow instrument; Mayo Elbow Performance Index; and Disabilities of the Arm, Shoulder and Hand questionnaire at a mean of 36 months. Radiologic assessment included radiographs and computed tomography to evaluate olecranon wear and densitometry (dual-energy x-ray absorptiometry). Range of motion, pain, and elbow satisfaction were recorded, and descriptive statistics were used for analysis.
  
  
  RESULTS
  Seven patients were available to participate in the follow-up examination. Acute cases (5 patients) scored better than salvage cases (2 patients) on the Mayo Elbow Performance Score (80 points [range, 67-95 points] and 65 points [range, 50-80 points], respectively) and Disabilities of the Arm, Shoulder and Hand score (31 points [range, 2.5-68 points] and 39 points [range, 17-62 points], respectively). The mean arc of elbow flexion and extension was 96° (range, 70°-130°), with mean flexion of 120° (range, 90°-135°) and a mean extension loss of 19° (range, 5°-30°). The mean arc of forearm rotation was 160° (range, 140°-180°). Reoperation was required in 4 patients because of painful retained hardware. Five patients reported pain with activities of daily living.
  
  
  CONCLUSIONS
  DHH should be used with caution until such time as longer-term outcome studies are able to show the efficacy of this procedure.
authors.affiliation: Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA. Electronic address: donaldhohman@gmail.com.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Hohman
authors.affiliation: Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Nodzo
authors.affiliation: Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Lars M
authors.initials: LM
authors.lastname: Qvick
authors.affiliation: Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Duquin
authors.affiliation: Department of Orthopedics, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Paterson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery*; D062785:Hemiarthroplasty; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Case Series; Hemiarthroplasty; Level IV; Treatment Study; arthroplasty; clinical outcome; distal humerus; elbow; fracture