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Distal humeral hemiarthroplasty: indications, results, and complications. A systematic review

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HAND

Abstract

Background

Distal humeral hemiarthroplasty (DHH) is a treatment option for unreconstructable intra-articular distal humerus fractures. DHH may also be used in the setting of rheumatoid arthritis, orthopaedic tumor with significant bone loss, malunion, or osteomyelitis. DHH has specific advantages over other, more common, treatment modalities: total elbow arthroplasty (TEA) and open reduction internal fixation (ORIF). DHH is especially a reasonable option in younger patients to preserve bone stock, avoid significant weight restrictions, and limit loosening.

Methods

The literature was reviewed for all cases of DHH for fracture and non-fracture indications between 1947 and 2014. Two hundred thirty-six papers were identified; 4 studies including 17 patients met criteria for non-fracture indications and 13 studies including 116 patients were identified for fracture indications. A systematic review was generated; patient indications, outcomes, and complications were recorded.

Results

For non-fracture indications, good to excellent results were achieved in 76.5 % of patients with a mean arc of motion of 62° at mean follow up of 46.3 months. Half of the patients experienced a complication, most commonly stiffness. Loosening of the prosthesis was not noted in any patient. For fractures, good to excellent results were achieved in 67.4 % of patients with a mean arc of motion of 98.3° at a mean follow up of 42.2 months. One third of the patients experienced a complication but only 1.7 % experienced loosening of the prosthesis.

Conclusion

Here, we present the first review of the indications for DHH. DHH is a reasonable treatment option for older patients with unreconstructable intra-articular fractures of the distal humerus as well as younger patients with rheumatoid arthritis, orthopaedic tumor with significant bone loss, malunion, or osteomyelitis.

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Conflict of Interest

John Dunn declares that he has no conflict of interest.

Nicholas Kusnezov declares that he has no conflict of interest.

Miguel Pirela-Cruz declares that he has no conflict of interest.

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This article does not contain any studies with human or animal subjects.

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Authors and Affiliations

  1. William Beaumont Army Medical Center, Department of Orthopaedic Surgery, 5005 N Piedras, Fort Bliss, TX, 79920, USA

    John Dunn & Nicholas Kusnezov

  2. Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX, 79920, USA

    Miguel Pirela-Cruz

Authors
  1. John Dunn
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  2. Nicholas Kusnezov
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  3. Miguel Pirela-Cruz
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Correspondence to John Dunn.

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Informed consent is not necessary in this study, as it is a review of previously published literature.

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Dunn, J., Kusnezov, N. & Pirela-Cruz, M. Distal humeral hemiarthroplasty: indications, results, and complications. A systematic review. HAND 9, 406–412 (2014). https://doi.org/10.1007/s11552-014-9681-3

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