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Megaprosthetic replacement in complex distal humerus fractures in elderly patients: a case series.
- Source :
-
Journal of orthopaedic surgery and research [J Orthop Surg Res] 2024 Jan 11; Vol. 19 (1), pp. 53. Date of Electronic Publication: 2024 Jan 11. - Publication Year :
- 2024
-
Abstract
- Background: Managing distal humeral fractures can be challenging for orthopedic surgeons. There are several treatment options for managing this type of fracture, and the treatment method for these fractures should be based on patient-related factors. In elderly patients with osteoporotic bone and severe comminution of the fracture, adequate fixation can be a major challenge for surgeons. The use of megaprosthesis has been recently proposed in traumatology as an alternative to osteosynthesis or conventional prosthesis for the management of comminuted articular fractures in elderly patients with poor bone stock.<br />Methods: A consecutive case series of 5 patients who underwent reconstruction of the elbow joint with a trabecular hinged modular elbow megaprosthesis was reviewed retrospectively. All patients included had AO/OTA 13C2 and 13C3 fractures with metaphyseal extension and considerable bone loss of the distal humerus. The primary outcome was the evaluation of functional and clinical outcomes with the MEPS score in comminuted distal humerus fractures with metaphyseal extension and poor bone stock in elderly patients treated with elbow megaprosthesis. The secondary outcome was assessing the treatment-related complication rate of this technique in non-oncological fields.<br />Results: Five patients were included in the study with a mean age of 82.66 ± 7.72 years at surgery. The mean MEPS value was 63 ± 24.2 at 1 month, 81 ± 23.53 at 3 months, 83 ± 24.2 at 6 months, and 84 ± 24.57 at 12 months. No intraoperative complications were recorded in our series. Of 5 patients, four patients had excellent clinical and functional outcomes. We did not encounter wound dehiscence, prosthetic joint infection, aseptic loosening, or periprosthetic fractures.<br />Conclusions: The indication for this type of treatment must be selected and narrowed down, as it is a salvage procedure, and any failure would cause even more complex situations. Short operating times and early mobilization of the elbow are the advantages of this technique.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Aged
Aged, 80 and over
Retrospective Studies
Treatment Outcome
Humerus
Fracture Fixation, Internal methods
Range of Motion, Articular
Elbow Joint diagnostic imaging
Elbow Joint surgery
Humeral Fractures, Distal
Humeral Fractures diagnostic imaging
Humeral Fractures surgery
Fractures, Comminuted diagnostic imaging
Fractures, Comminuted surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1749-799X
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic surgery and research
- Publication Type :
- Academic Journal
- Accession number :
- 38212796
- Full Text :
- https://doi.org/10.1186/s13018-023-04465-2