Lee Keng Thiam, Lai Choon Hin, Singh Sarbjit
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
J Trauma. 2006 Oct;61(4):889-92. doi: 10.1097/01.ta.0000215421.77665.7a.
Distal humerus fractures in elderly patients are difficult to treat as these fractures are often complicated by varying degrees of comminution intra-articular involvement and osteoporosis. We retrospectively reviewed the results of primary total elbow arthroplasty in the treatment of distal humerus fractures in seven patients followed for a minimum of 1 year.
Between July 2000 and June 2002, seven patients with distal humerus fractures were treated electively with total elbow arthroplasty using the semiconstrained Coonrad-Moorey elbow replacement prostheses. The Mayo Elbow Performance Score was used to assess the outcomes.
The mean age of our patients was 72.9 years. The mean duration of postoperative hospitalization stay was 7.6 days. The average length of follow up was 24.9 months. Six of these patients had no pain, and one patient had mild pain. The mean arc of flexion was 88.6 degrees. Six elbows had excellent results, while 1 elbow had good result. The mean Mayo score was 94.3 points. One elbow developed blisters postoperatively but resolved with dressings and antibiotics.
Our review suggests that total elbow arthroplasty can give good to excellent short term results when used in the treatment of distal humerus fractures in elderly Asian patients.
老年患者的肱骨远端骨折治疗困难，因为这些骨折常伴有不同程度的粉碎、关节内受累及骨质疏松。我们回顾性分析了7例接受初次全肘关节置换术治疗肱骨远端骨折且随访至少1年患者的结果。
2000年7月至2002年6月，7例肱骨远端骨折患者接受了半限制性Coonrad-Moorey肘关节置换假体的全肘关节置换术。采用Mayo肘关节功能评分评估疗效。
患者的平均年龄为72.9岁。术后平均住院时间为7.6天。平均随访时间为24.9个月。其中6例患者无疼痛，1例患者有轻度疼痛。平均屈曲弧度为88.6度。6例肘关节效果极佳，1例肘关节效果良好。Mayo评分平均为94.3分。1例肘关节术后出现水泡，但经换药及使用抗生素后痊愈。
我们的回顾性分析表明，全肘关节置换术用于治疗亚洲老年患者的肱骨远端骨折时，可取得良好至极佳的短期效果。
