title: Is Coonrad-Morrey total elbow arthroplasty a viable option for treatment of distal humeral nonunions in the elderly?
abstract: OBJECTIVE
  The purpose of this study was to evaluate the functional and radiological results of semiconstrained Coonrad-Morrey total elbow arthroplasty for distal humeral nonunions in the mid-term period.
  
  
  METHODS
  Seven patients were treated with Coonrad-Morrey total elbow arthroplasty for distal humeral nonunion. All patients were female, and the mean age was 65.6 years (range: 64-68 years). Patients were followed for at least 5 years, and the mean follow-up time was 73 months (range: 63-84 months). Anteroposterior and lateral radiographs at preoperative and early postoperative period of the joint replacement and latest follow-up were used to detect postoperative radiological changes in terms of loosening. The Mayo Elbow Performance Index (MEPI) and Q-DASH Score were used for functional evaluation.
  
  
  RESULTS
  At the latest follow-up, joint stability had been achieved in all 7 patients. Six patients (85.7%) were pain free. The mean range of motion was 30° (range: 0-60°) preoperatively, and this improved to 90.7° (range: 60-110°) at the latest follow-up (p<0.05). Five patients (71.4%) had excellent or good outcomes on the MEPI. The mean Q-DASH Score was improved from 93.2 to 34.5 (p<0.01). Two humeral components had aseptic loosening, and 1 of them was revised.
  
  
  CONCLUSIONS
  Semiconstrained total elbow arthroplasty can be a reliable choice of treatment if other internal fixation methods fail. Significant pain relief and improvements in elbow function and stability can be achieved with semiconstrained elbow arthroplasty in patients with distal humeral nonunion.
authors: İstanbul University İstanbul Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey. ali_ersen@hotmail.com.
authors: Ali
authors: A
authors: Erşen
authors: Koç University School of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors: Mehmet
authors: M
authors: Demirhan
authors: İstanbul University İstanbul Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors: Ata Can
authors: AC
authors: Atalar
authors: Uludağ University Faculty of Medicine, Department of Orthopedics and Traumatology, Bursa, Turkey.
authors: Teoman
authors: T
authors: Atıcı
authors: İstanbul University İstanbul Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors: Mehmet
authors: M
authors: Kapıcıoğlu
mesh_terms: D000368:Aged; D057929:Arthroplasty, Replacement, Elbow / Q000009:adverse effects*; D004550:Elbow; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D058569:Elbow Prosthesis / Q000009:adverse effects*; D004838:Epiphyses / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006811:Humerus / Q000601:surgery; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome