Gallucci G L, Larrondo Calderón W, Boretto J G, Castellaro Lantermo J A, Terán J, de Carli P
Servicio de Ortopedia y Traumatología «Dr. Carlos E. Ottolenghi», Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Servicio de Traumatología, Clínica Dávila, Santiago, Chile.
Rev Esp Cir Ortop Traumatol. 2016 May-Jun;60(3):167-74. doi: 10.1016/j.recot.2015.12.004. Epub 2016 Mar 2.
To report the clinical-functional outcomes of the treatment of humeral distal fractures with a total elbow prosthesis.
This retrospective study was performed in two surgical centres. A total of 23patients were included, with a mean age of 79years, and of which 21 were women. The inclusion criteria were: patients with humeral distal fractures, operated on using a Coonrad-Morrey prosthesis, and with a follow-up of more than one year. According to AO classification, 15fractures were type C3, 7 C2 and 1 A2. All patients were operated on without de-insertion of the extensor mechanism. The mean follow-up was 40 months.
Flexor-extension was 123-17°, with a total mobility arc of 106° (80% of the contralateral side). Pain, according to a visual analogue scale was 1. The Mayo Elbow Performance Index (MEPI) was 83 points. Excellent results were obtained in 8 patients, good in 13, medium in 1, and poor in 1. The mean DASH (disability) score was 24 points.
Treatment of humeral distal fractures with total elbow arthroplasty could be a good treatment option, but indications must be limited to patients with complex fractures, poor bone quality, with osteoporosis and low functional demands. In younger patients, the use is limited to serious cases where there is no other treatment option.
Level of Evidence IV.
报告采用全肘关节假体治疗肱骨远端骨折的临床功能结果。
这项回顾性研究在两个外科中心进行。共纳入23例患者，平均年龄79岁，其中21例为女性。纳入标准为：肱骨远端骨折患者，采用Coonrad-Morrey假体进行手术，且随访时间超过一年。根据AO分类，15例骨折为C3型，7例为C2型，1例为A2型。所有患者手术时均未切断伸肌机制。平均随访时间为40个月。
屈伸活动度为123°-17°，总活动弧度为106°（对侧的80%）。根据视觉模拟评分法，疼痛评分为1分。梅奥肘关节功能指数（MEPI）为83分。8例患者结果优秀，13例良好，1例中等，1例差。平均DASH（功能障碍）评分为24分。
全肘关节置换术治疗肱骨远端骨折可能是一种较好的治疗选择，但适应证必须限于复杂骨折、骨质差、患有骨质疏松症且功能需求较低的患者。对于年轻患者，仅适用于没有其他治疗选择的严重病例。
证据水平IV。
