Wilfred Ann M, Akhter Shakib, Horner Nolan S, Aljedani Ahmed, Khan Moin, Alolabi Bashar
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Shoulder Elbow. 2022 Feb;14(1):65-74. doi: 10.1177/17585732211023100. Epub 2021 Jun 17.
Distal humeral hemiarthroplasty has been performed for a variety of indications with the most common being management of distal humeral fractures. This systematic review evaluates the outcomes and complications of distal humeral hemiarthroplasty for this pathology.
We searched PubMed, EMBASE, and MEDLINE for studies reporting indications and outcomes of patients undergoing distal humeral hemiarthroplasty. Study screening, risk of bias assessment, and data extraction were performed. Summery statistics were provided.
We included 11 studies ( = 163) in this review. In all studies, the indication for distal humeral hemiarthroplasty was the presence of an intraarticular, comminuted, unreconstructable fracture. The mean post-operative MEPS, FullDASH, and QuickDASH (SD) scores were 83.6 (6.1) points, 25.4 (10.3), and 15.7 (7.4) points, respectively. The mean post-operative range of motion (SD) was 106° (11°) in the flexion and extension arc and 153° (19°) in the protonation and supination arc. The overall rate of adverse events and complication was 63%. The rate for major complications was 11%. The mean total revision rate was 4% (0% to 15) and total re-operation rate was 29% (0% to 88%).
Distal humeral hemiarthroplasty is a suitable option for unreconstructable distal humeral fractures and offers good functional outcomes with acceptable complication rates.
肱骨远端半关节置换术已用于多种适应证，最常见的是处理肱骨远端骨折。本系统评价评估了针对该病症的肱骨远端半关节置换术的疗效和并发症。
我们在PubMed、EMBASE和MEDLINE中检索了报告肱骨远端半关节置换术患者适应证和疗效的研究。进行了研究筛选、偏倚风险评估和数据提取，并提供了汇总统计数据。
本评价纳入了11项研究（n = 163）。在所有研究中，肱骨远端半关节置换术的适应证均为存在关节内、粉碎性、无法重建的骨折。术后平均MEPS、FullDASH和QuickDASH（标准差）评分分别为83.6（6.1）分、25.4（10.3）分和15.7（7.4）分。术后屈伸弧平均活动范围（标准差）为106°（11°），旋前旋后弧平均活动范围为153°（19°）。不良事件和并发症的总体发生率为63%。主要并发症发生率为11%。平均总翻修率为4%（0%至15%），总再次手术率为29%（0%至88%）。
肱骨远端半关节置换术是无法重建的肱骨远端骨折的合适选择，可提供良好的功能结局，并发症发生率可接受。
