Elbow Fracture: Treated with Replacement

Abstract

Over the past decade, there has been an increase in the number of total elbow arthroplasty procedures being done for acute fractures of the distal humerus in elderly patients. This is in part due to the difficulty in obtaining adequate internal fixation in osteoporotic bone, especially in the short distal articular fracture fragment of the distal humerus. Also, these patients may have associated medical problems in addition to the osteoporosis that interfere with bone healing such as diabetes, renal disease, and vascular disease. Several studies have highlighted the benefits of arthroplasty over internal fixation, including better short-term functional outcome scores. At the same time, total elbow arthroplasty is not without complications and is a procedure best performed by a surgeon familiar with the technique. This case study involves an elderly woman with a distal humerus fracture treated with total elbow replacement. She benefitted from an early return to function that allowed her to maximize what remained of her time. She died of natural causes 18 months after surgery.