Osma-Rueda JL, Amaya-Mujica J

Language: Spanish
References: 13
Page: 252-255
PDF size: 167.31 Kb.

ABSTRACT

Introduction: Distal humeral fractures in the elderly patient are a therapeutic challenge for orthopaedists, because of age’s characteristic physiological conditions and bone changes. Case report: We present the case of an 80-year-old woman with osteopenia, who had distal humeral fracture due to a fall from her own height; she was initially treated conservatively, but by the reason of a non-union, we decided to perform a total elbow arthroplasty, achieving a positive functional result in the four years of postoperative follow-up. Discussion: Nonsurgical management is an option for treat humeral fractures in patients with low functional demands or in poor general condition. If the patient does not present the conditions above, or if nonsurgical management fails, a total elbow arthroplasty must be performed, because this method provides a rapid recovering if compared to an open reduction and osteosynthesis material management.

REFERENCES

1. Clavert P, Ducrot G, Sirveaux F, Fabre T, Mansat P, SOFCOT. Outcomes of distal humerus fractures in patients above 65 years of age treated by plate fixation. Orthop Traumatol Surg Res. 2013; 99(7): 771-7.

2. Charissoux JL, Vergnenegre G, Pelissier M, Fabre T, Mansat P, SOFCOT. Epidemiology of distal humerus fractures in the elderly. Orthop Traumatol Surg Res. 2013; 99(7): 765-9.

3. Chalidis B, Dimitriou C, Papadopoulos P, Petsatodis G, Giannoudis PV. Total elbow arthroplasty for the treatment of insufficient distal humeral fractures. A retrospective clinical study and review of the literature. Injury. 2009; 40(6): 582-90.

4. Prasad N, Ali A, Stanley D. Total elbow arthroplasty for non-rheumatoid patients with a fracture of the distal humerus. A minimun ten-year follow-up. Bone Joint J. 2016; 98(3): 381-6.

5. Mitsunaga MM, Bryan RS, Linscheid RL. Condylar nonunions of the elbow. J Trauma. 1982; 22(9): 787-91.

6. Bryan RS, Morrey BF. Extensive posterior exposure of the elbow. A triceps-sparing approach. Clin Orthop Relat Res. 1982; 166: 188-92.

7. Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW. Accuracy and reliability of the mayo elbow performance score. J Hand Surg Am. 2014; 39(6): 1146-50. Available from: https://www.jhandsurg.org/article/S0363-5023(14)00211-1/fulltext.

8. Varecka TF, Myeroff C. Distal humerus fractures in the elderly population. J Am Acad Orthop Surg. 2017; 25 (10): 673-83.

9. Desloges W, Faber KJ, King GJ, Athwal GS. Functional outcomes of distal humeral fractures managed nonoperatively in medically unwell and lower-demand elderly patients. J Shoulder Elbow Surg. 2015; 24(8): 1187-96. Available from: http://dx.doi.org/10.1016/j.jse.2015.05.032.

10. UI Islam S, Glover AW, Waseem M. Challenges and solutions in management of distal humerus fractures. Open Orthop J. 2017; 11: 1292-307.

11. Rajaee SS, Lin CA, Moon CN. Primary total elbow arthroplasty for distal humeral fractures in elderly patients: a nationwide analysis. J Shoulder Elbow Surg. 2016; 25(11): 1854-60.

12. Githens M, Yao J, Sox AH, Bishop J. Open reduction and internal fixation versus total elbow arthroplasty for the treatment of geriatric distal humerus fractures: a systematic review and meta-analysis. J Orthop Trauma. 2014; 28(8): 481-8.

13. Pogliacomi F, Aliani D, Cavaciocchi M, Corradi M, Ceccarelli F, Rotini R. Total elbow arthroplasty in distal humeral nonunion: clinical and radiographic evaluation after a minimum follow-up of three years. J Shoulder Elbow Surg. 2015; 24(12): 1998-2007.