Periprosthetic Fractures after Total Elbow Replacement

Lee,  Sang Myung; Park,  Jae Chul; Song,  Seok Whan; Park,  Jong Min; Ryu,  Ji Hyun; Rhee,  Seung Koo; Lee,  Yoon Min

Journal of the Korean Society for Surgery of the Hand 2010;15(3):107-111.
Published online September 1, 2010.

Sang Myung Lee, Jae Chul Park, Seok Whan Song, Jong Min Park, Ji Hyun Ryu, Seung Koo Rhee, Yoon Min Lee

Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, Catholic University Medical College, Seoul, Korea. skrhee@catholic.ac.kr

Abstract

Purpose
To analyze clinical presentation and results of the treatment of periprosthetic fractures occurring after total elbow replacement (TER). MATERIALS AND METHODS: Eleven patients who had periprosthetic fractures after TER were examined. The locations and the causes of periprosthetic fractures were evaluated. The periprosthetic fractures were classified using Mayo classification. Stable fractures were treated conservatively, and unstable fractures were treated by open reduction and internal fixation. Revision operation was conducted if implant loosening was observed. End results after treatment were evaluated based on Mayo elbow performance score (MEPS) and radiologic examinations.

Results
Most fractures occurred at the humeral site(82%), and Type B2 periprosthetic fracture was most frequently observed(64%). Radiographic union was observed at a mean of 26 weeks after the treatment. No statistically significant differences were observed between preoperative and postoperative elbow active motions. According to the MEPS, the results were rated as excellent in three patients, good in five, fair in one and poor in two.

Conclusion
A periprosthetic fracture after TER likely occurrs at humeral site and it is highly related with loosening of the implant. Although union tends to be delayed and complications occur frequently, relatively fair results can be obtained with appropriate treatment.