title: Total elbow arthroplasty for non-rheumatoid patients with a fracture of the distal humerus: a minimum ten-year follow-up.
abstract: OBJECTIVE
  We review our experience of Coonrad-Morrey total elbow arthroplasty (TEA) for fractures of the distal humerus in non-rheumatoid patients with a minimum of ten years follow-up.
  
  
  METHODS
  TEA through a triceps splitting approach was peformed in 37 non-rheumatoid patients for a fracture of the distal humerus between 1996 and 2004. One patient could not be traced and 17 had died before the tenth anniversary of their surgery. This left 19 patients with a minimum follow-up of ten years to form the study group. Of these, 13 patients were alive at the time of final review. The other six had died, but after the tenth anniversary of their elbow arthroplasty. Their clinical and radiological data were included in the study.
  
  
  RESULTS
  The mean follow-up of the 19 patients was 156 months (120 to 210). Two patients in the study group had undergone revision. One further patient had undergone a two-stage revision for infection but died before ten-year follow-up. Six other patients in the study group had evidence of loosening or wear of their bushings. Two were clinically symptomatic and were offered revision surgery. Male patients showed higher incidence of loosening and wear. Survivorship, with revision and definite loosening as end-points, was 89.5% at ten years in those patients followed for a minimum of ten years and 86% in the whole group of 36 patients.
  
  
  CONCLUSIONS
  This study shows that only 53% of non-rheumatoid patients who undergo TEA for a fracture of the distal humerus survive to the tenth anniversary of their index procedure. For those that survive, TEA provides acceptable outcomes in terms of function and implant survival.
  
  
  CONCLUSIONS
  The surgeons undertaking these procedures should be aware of the long-term revision rates and also the gender difference in the rates of loosening.
authors.affiliation: Tameside NHS Trust, Fountain Street, Ashton-U-Lyne Lancashire OL6 9RW, UK.
authors.forename: N
authors.initials: N
authors.lastname: Prasad
authors.affiliation: Sheffield Teaching Hospital NHS Trust, Herries Road, Sheffield S5 7AU, UK.
authors.forename: A
authors.initials: A
authors.lastname: Ali
authors.affiliation: Thornbury Hospital, Fulwood Road, Sheffield, S10 3BR, UK.
authors.forename: D
authors.initials: D
authors.lastname: Stanley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid; D057929:Arthroplasty, Replacement, Elbow / Q000009:adverse effects / Q000379:methods*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D058569:Elbow Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012737:Sex Factors; D000092464:Elbow Injuries
keywords: Coonrad-Morrey; Elbow arthroplasty; distal humerus fracture