This is a retrospective review of 9 patients who underwent primary total elbow arthroplasty for the management of acute distal humerus fractures using an unlinked elbow prosthesis. The patients were evaluated with the Mayo Elbow Performance Score and the recently developed Liverpool elbow score.
Results indicate that all elbows were stable at follow-up at a mean of 3.5 years. All patients were able to perform their activities of daily living and pain relief was satisfactory. The median Mayo score was 95.
The results indicate that unlinked total elbow arthroplasty may be a reasonable option for comminuted distal humerus fractures in the elderly. As one often loses bone stock distally in these fractures, the humeral stem must be cemented into the shaft more proximally without distal support. As such, this procedure should probably be reserved for the elderly, lower demand patient where there is less concern regarding loosening. This is especially true when using semi-constrained devices that have a higher incidence of loosening and mechanical failure.