Erşen Ali, Demirhan Mehmet, Atalar Ata Can, Atıcı Teoman, Kapıcıoğlu Mehmet
İstanbul University İstanbul Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Koç University School of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Acta Orthop Traumatol Turc. 2015;49(4):354-60. doi: 10.3944/AOTT.2015.14.0309.
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.
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.
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.
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.
本研究旨在评估半限制性Coonrad-Morrey全肘关节置换术治疗肱骨远端骨不连的中期功能和影像学结果。
7例患者接受Coonrad-Morrey全肘关节置换术治疗肱骨远端骨不连。所有患者均为女性，平均年龄65.6岁（范围：64 - 68岁）。患者随访至少5年，平均随访时间为73个月（范围：63 - 84个月）。使用关节置换术前、术后早期及最新随访时的正侧位X线片检测术后松动方面的影像学变化。采用梅奥肘关节功能指数（MEPI）和Q-DASH评分进行功能评估。
在最新随访时，所有7例患者均实现了关节稳定。6例患者（85.7%）无疼痛。术前平均活动范围为30°（范围：0 - 60°），在最新随访时改善至90.7°（范围：60 - 110°）（p<0.05）。5例患者（71.4%）在MEPI上获得优秀或良好结果。平均Q-DASH评分从93.2改善至34.5（p<0.01）。2个肱骨假体出现无菌性松动，其中1个进行了翻修。
如果其他内固定方法失败，半限制性全肘关节置换术可以是一种可靠的治疗选择。半限制性肘关节置换术可使肱骨远端骨不连患者的疼痛显著减轻，肘关节功能和稳定性得到改善。
