Clin Should Elbow.  2018 Sep;21(3):120-126. 10.5397/cise.2018.21.3.120.

Hemiarthroplasty for Distal Humerus Fracture: A Systematic Review and Meta-analysis for Functional Outcome

• Kwak JM
• Kholinne E
• Sun Y
• Lee GB
• Koh KH
• Chun JM
• Jeon IH

• KMID: 2436396
• DOI: http://doi.org/10.5397/cise.2018.21.3.120

Abstract

BACKGROUND
Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures.
METHODS
We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included "˜distal humerus fracture' and "˜hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed.
RESULTS
Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion (107.6° flexion-extension, 157.5° for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range.
CONCLUSIONS
Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

Keyword

Hemiarthroplasty; Humerus; Elbow; Fracture; Meta analysis

MeSH Terms

Aged
Arm
Arthroplasty
Demography
Elbow
Follow-Up Studies
Hand
Hemiarthroplasty*
Humans
Humeral Fractures
Humerus*
Outcome Assessment (Health Care)
Range of Motion, Articular
Shoulder
Tea
Tea