title: Total elbow joint replacement for fractures in the elderly--Functional and radiological outcomes.
abstract: OBJECTIVE
  The purpose of this paper was to review the literature on the treatment of intra-articular fractures of the distal humerus in the elderly in order to evaluate the place for total elbow replacement (TER) in the light of our experience over the past 15 years.
  
  
  METHODS
  A review of the records of 11 consecutive patients over the age of 60 years who underwent primary TER for comminuted fractures of the distal humerus between 1997 and 2011 were reviewed and the surviving patients were interviewed. The Scopus database was used to perform a pragmatic review of the literature published between the mid-1990s and the present-day.
  
  
  RESULTS
  At the time of the most recent follow-up 3.5 years following surgery (range: 2-6 years) 7 patients assessed with the Mayo elbow performance index were classified as excellent, 4 were classified as good. There were no complications requiring further procedures encountered. Five surviving patients remain satisfied with the function of their TER. The number of papers recommending TER for treatment of these fractures continues to increase with time.
  
  
  CONCLUSIONS
  TER is now the treatment of choice for unreconstructable fractures of the distal humerus in the elderly. This option should therefore be available at the time of surgery for all distal humeral fractures in this patient population. A surgical approach other than olecranon osteotomy, which would preclude TER is therefore required.
authors.affiliation: Queen Elizabeth Hospital, Gateshead NE9 6SX, UK. Electronic address: pooleyjoseph@btconnect.com.
authors.forename: Joseph
authors.initials: J
authors.lastname: Pooley
authors.affiliation: Hospital Universitari Mutua Terassa, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salvador Carreno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057929:Arthroplasty, Replacement, Elbow / Q000379:methods; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D018460:Fractures, Comminuted / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000503:physiopathology / Q000601:surgery*; D057072:Intra-Articular Fractures / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D017410:Practice Guidelines as Topic; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Distal humerus fractures; Elderly fragility fractures; Total elbow arthroplasty