J Korean Fract Soc.  2000 Jan;13(1):193-199. 10.12671/jksf.2000.13.1.193.

Treatment of Periprosthetic Fracture Following Total Elbow arthroplasty

• Yoo MC
• Rhee YG
• Cho YJ
• Kim KI
• Cho YL

• KMID: 2100098
• DOI: http://doi.org/10.12671/jksf.2000.13.1.193

Abstract

PURPOSE
: To classify the pattern of periprosthetic fracture after total elbow replacement(TER) and introduce the principles of treatment in various fracture patterns.
MATERIALS AND METHODS
: Four patients(1 man and 3 women) were evaluated, who had periprosthetic fractures following total elbow arthroplasty, form July 1997 to October 1998. The incidence of fracture among TERs was 6%(4/62) and the average follow-up period was 1 year 6 months. The locations of periprosthetic fractures were classified according to Hanyu et al. The result were analyzed about the treatment modalities, the period to bony union, elbow motion and complication.
RESULTS
: Type2 and type 3 fractures were treated with closed reduction and hanging splint, whereas type 1 fracture showing loosening of humeral component was treated with revision arthroplasty. Type 4 fracture was treated with open reduction and internal fixation. The period to bone union was 5 months in average. The elbow motion ranged between 7.5degrees to 106.2degrees at the last follow-up. Type 3 showed anterior angulation deformity of 20degrees.
CONCLUSION
: Fracture pattern, stability, and loosing of component should be considered to select treatment modality. In transverse fracture proximal to the humeral stem tip(type 3), open reduction and internal fixation is recommended because of difficulties in maintaining alignment of fracture fragment. Postoperative rehabilitation program is very important to prevent limitation of elbow motion

Keyword

Total elbow arthroplasty; Periprosthetic fracture

MeSH Terms

Arthroplasty*
Congenital Abnormalities
Elbow*
Follow-Up Studies
Incidence
Periprosthetic Fractures*
Rehabilitation
Splints