Immediate Total Elbow Arthroplasty Following Olecranon Osteotomy: A Case Report

Abstract

Consistent with an aging population, the overall number of distal humeral fractures in the elderly is increasing. Indications for application of acute total elbow arthroplasty (TEA) in the setting of distal humeral fractures are still being defined. A variety of factors including chronologic age, physiologic age, bone quality, presence of pre-existing arthritis and pre-existing medical conditions need to be considered. Optimally the decision to proceed with TEA verses open reduction internal fixation (ORIF) is made preoperatively. The need to abandon ORIF may be not be apparent until after fracture exposure, and the presence of an olecranon osteotomy makes performing TEA challenging. A case is presented of acute conversion from ORIF to TEA following olecranon osteotomy, utilizing internal fixation bridging the ulnar component and its cement mantle.

Share and Cite:

L. Reichel, C. Hillin and C. Reitman, "Immediate Total Elbow Arthroplasty Following Olecranon Osteotomy: A Case Report," Open Journal of Orthopedics, Vol. 3 No. 4, 2013, pp. 213-216. doi: 10.4236/ojo.2013.34039.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. B. Jupiter, U. Neff, P. Holzach and M. Allgower, “Intercondylar Fractures of the Humerus. An Operative Approach,” The Journal of Bone and Joint Surgery American Volume, Vol. 67, No. 2, 1985, pp. 226-239.
[2] A. Nauth, M. D. McKee, B. Ristevski, J. Hall and E. H. Schemitsch, “Distal Humeral Fractures in Adults,” The Journal of Bone and Joint Surgery American Volume, Vol. 93, No. 7, 2011, pp. 686-700. doi:10.2106/JBJS.J.00845
[3] M. Palvanen, P. Kannus, S. Niemi and J. Parkkari, “Secular Trends in Distal Humeral Fractures of Elderly Women: Nationwide Statistics in Finland between 1970 and 2007,” Bone, Vol. 46, No. 5, 2010, pp. 1355-1358. doi:10.1016/j.bone.2009.11.025
[4] M. D. McKee, C. J. H. Veillette, J. A. Hall, E. H. Schemitsch, L. M. Wild, R. McCormack, et al., “A Multicenter, Prospective, Randomized, Controlled Trial of Open Reduction—Internal Fixation versus Total Elbow Arthroplasty for Displaced Intra-Articular Distal Humeral Fractures in Elderly Patients,” Journal of Shoulder and Elbow Surgery/American Shoulder and Elbow Surgeons, Vol. 18 No. 1, 2009, pp. 3-12.
[5] M. A. Frankle, D. Herscovici, T. G. DiPasquale, M. B. Vasey and R. W. Sanders, “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,” Journal of Orthopaedic Trauma, Vol. 17, No. 7, 2003, pp. 473-480. doi:10.1097/00005131-200308000-00001
[6] G. Marra, B. F. Morrey, S. H. Gallay, M. D. McKee and S. O’Driscoll, “Fracture and Nonunion of the Olecranon in Total Elbow Arthroplasty,” Journal of Shoulder and Elbow Surgery/American Shoulder and Elbow Surgeons, Vol. 15, No. 4, 2006, pp. 486-494.
[7] T. K. Cobb and B. F. Morrey, “Total Elbow Arthroplasty as Primary Treatment for Distal Humeral Fractures in Elderly Patients,” The Journal of Bone and Joint Surgery. American Volume, Vol. 79, No. 6, 1997, pp. 826-832.
[8] R. Gambirasio, N. Riand, R. Stern and P. Hoffmeyer, “Total Elbow Replacement for Complex Fractures of the Distal Humerus. An Option for the Elderly Patient,” The Journal of Bone and Joint Surgery British Volume, Vol. 83, No. 7, 2001, pp. 974-978. doi:10.1302/0301-620X.83B7.11867
[9] A. Ali, S. Shahane and D. Stanley, “Total Elbow Arthroplasty for Distal Humeral Fractures: Indications, Surgical Approach, Technical Tips, and Outcome,” Journal of Shoulder and Elbow Surgery/American Shoulder and Elbow Surgeons, Vol. 19, No. 2, 2010, pp. 53-58.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.