Department of Orthopaedics, Linköping University Hospital, Linköping, Sweden.
J Shoulder Elbow Surg. 2012 Apr;21(4):451-5. doi: 10.1016/j.jse.2011.07.011. Epub 2011 Oct 17.
Treatment of intra-articular fractures of the distal humerus in the elderly is challenging. In patients with very distal fractures and severe comminution, primary arthroplasty has been advocated. Recently, a few reports have described promising results of hemiarthroplasty. This study describes the medium-term results of using the Kudo humeral implant (Biomet Ltd, Bridgend, U.K.) as replacement of the distal humerus.
Eight women (mean age, 79 years) were treated. Follow-up was conducted at a mean of 4 years after the procedure and consisted of the Mayo Elbow Performance Score (MEPS), radiographic images, and range of motion (ROM).
All patients had a good or excellent outcome according to the MEPS. Mean ROM was 31° to 126°. Radiographic signs of attrition of the ulna were observed in 3 patients but did not correlate with the functional outcome. A periprosthetic fracture occurred in 1 patient 3 years after the index operation, and ROM was unsatisfactory in 1 patient. No other complications were observed.
The use of the Kudo humeral implant as a hemiarthroplasty resulted in a reasonable functional outcome in the medium-term, but the radiographic signs of attrition suggest that the implant is not recommended as a hemiprosthesis.
老年人关节内肱骨远端骨折的治疗具有挑战性。对于非常远端的骨折和严重粉碎的患者，提倡进行原发性关节置换术。最近，有一些报道描述了半关节成形术的可喜结果。本研究描述了使用 Kudo 肱骨植入物（英国 Biomet Ltd，Bridgend）作为肱骨远端置换的中期结果。
8 名女性（平均年龄 79 岁）接受了治疗。术后平均随访 4 年，包括 Mayo 肘功能评分（MEPS）、影像学图像和活动范围（ROM）。
所有患者根据 MEPS 均有良好或优秀的结果。平均 ROM 为 31°至 126°。3 名患者观察到尺骨磨损的放射学迹象，但与功能结果无关。1 名患者在索引手术后 3 年发生了假体周围骨折，1 名患者的 ROM 不满意。未观察到其他并发症。
使用 Kudo 肱骨植入物作为半关节成形术在中期获得了合理的功能结果，但磨损的放射学迹象表明该植入物不推荐作为半假体。
