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Fratture dell’omero distale: trattamento con protesi di gomito

  • Alice RitaliEmail author
  • Enrico Guerra
  • Marco Ricciarelli
  • Roberta Zaccaro
  • Roberto Rotini
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Elbow replacement for distal humeral fractures

Abstract

The treatment of distal humeral fractures could be challenging, especially in the older population. Although some fractures of the distal humerus in the elderly can be managed non-operatively, generally they results in poor outcome, secondary stiffness or nonunion. In young people and in patients with good bone quality, open reduction and stable internal fixation are mandatory, but in patients over 65 y-o, elbow prosthesis could be a good option for treatment. If the patient presents a complex pattern including fracture, osteoporosis, or joint damage from rheumatoid arthritis, total elbow replacement needs to be considered. By contrast, in case of more active patients distal humeral hemiarthroplasty is the ideal choice, being less invasive, with many advantages such as lower patient morbidity, less concerns regarding polyethylene wear, and bone stock preservation for future reconstructive procedures. In this study we reviewed 49 patients, with a mean age of 78. 4 year, who had been treated in our Unit between 2001–2016 for distal humeral fractures. All patients underwent joint replacement (either total elbow arthroplasty or distal humeral hemiartoplasty). The aim of this study was to assess the outcomes in patients treated with elbow replacement at medium-term follow-up and, consequently, to define an algorithm for the treatment of distal humeral fractures in elderly.

Notes

Conflitto di interesse

Gli autori Alice Ritali, Enrico Guerra, Marco Ricciarelli, Roberta Zaccaro e Roberto Rotini dichiarano di non aver alcun conflitto di interesse.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.

Bibliografia

  1. 1.
    Desloges W, Faber KJ, King GJ, Athwal GS (2015) Functional outcome of distal humeral fractures managed nonoperatively in medically unwell and lower demand elderly patients. J Shoulder Elb Surg 24:1187–1196 CrossRefGoogle Scholar
  2. 2.
    Cobb TK, Morrey BF (1997) Total elbow arthroplasty as primary treatment for distal humeral fractures in elderly patients. J Bone Jt Surg, Am 9(6):826–832 CrossRefGoogle Scholar
  3. 3.
    Morrey BF, Sanchez-Sotelo J, Morrey ME (2018) The elbow and its disorders. Elsevier, Philadelphia Google Scholar
  4. 4.
    Frankle Hersscovici MA, DiPasquale TG et al. (2003) A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65. J Orthop Trauma 17:473–480 CrossRefGoogle Scholar
  5. 5.
    Rotini R, Cavaciocchi M, Guerra E et al. (2015) Le protesi di gomito negli esiti traumatici. Lo Scalpello 29:181 CrossRefGoogle Scholar
  6. 6.
    Argintar E, Berry M, Narvy SJ et al. (2012) Hemiarthroplasty for the treatment of distal humerus fractures: short-term clinical results. Orthopedics 35(12):1042–1045 CrossRefGoogle Scholar
  7. 7.
    Rotini R, Antonioli D, Marinelli A, Guerra E (2007) Disegno e selezione dell’impianto nella protesi totale di gomito. GIOT 33(Suppl 1):S139–S143 Google Scholar
  8. 8.
    Barco R, Streubel PN, Morrey BF, Sanchez-Sotelo J (2017) Total elbow arthroplasty for distal humeral fractures, a ten-year-minimum follow-up study. J Bone Jt Surg, Am 99:1524–1531 CrossRefGoogle Scholar
  9. 9.
    Smith GC, Bayne G, Page R, Huges JS (2016) The clinical outcome and activity levels of patients under 55 years treated with distal humeral hemiarthroplasty for distal humeral fractures: minimum 2-year follow-up. Shoulder Elb 8(4):264–270 CrossRefGoogle Scholar
  10. 10.
    Schultzel M, Scheidt K, Itamura J et al. (2017) Hemiarthroplasty for the treatment of distal humeral fractures: midterm clinical results. J Shoulder Elb Surg 26:389–393 CrossRefGoogle Scholar
  11. 11.
    Mighell M, Virani M, Frankle M et al. (2006) Failed open reduction and internal fixation for elbow fractures converted to total elbow arthroplasty. In: American shoulder and elbow surgeons closed meeting, Chicago, IL Google Scholar

Copyright information

© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2019

Authors and Affiliations

  • Alice Ritali
    • 1
    Email author
  • Enrico Guerra
    • 1
  • Marco Ricciarelli
    • 1
  • Roberta Zaccaro
    • 1
  • Roberto Rotini
    • 1
  1. 1.S.C. Chirurgia Spalla e GomitoIRCCS Istituto Ortopedico RizzoliBolognaItalia

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