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Arthroplasty as primary treatment for distal humeral fractures produces reliable results with regards to revisions and adverse events: a registry-based study
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Department of Orthopedics, Elisabeth Hospital, Uppsala, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
2019 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 28, no 4, p. E104-E110Article in journal (Refereed) Published
Abstract [en]

Background

Primary prosthetic replacement has become an accepted method for the treatment of complex distal humeral fractures. The present study investigated implant survival and adverse events related to this procedure based on available Swedish registries and examined the completeness of the Swedish Elbow Arthroplasty register.

Materials and methods

Patients treated in Sweden with a primary elbow replacement due to a distal humeral fracture between 1999 and 2014 were identified through 3 different registries: The Swedish Elbow Arthroplasty Register, National Board of Health and Welfare inpatient register, and local registries of all orthopedic departments. Prosthetic survival was examined using Cox regression analysis with Kaplan-Meier plots. Adverse events, defined as medical treatment of the affected elbow besides revision, were analyzed separately. The study included 406 elbows in 405 patients, and no register was complete.

Results

Implant survival at 10 years was 90% (95% confidence interval, 85%-96%), but only 45 patients had an observation time of 10 years or more because 46% of the patients had died, resulting in a mean observation time of 67 (standard deviation, 47) months. An increase in the use of hemiarthroplasties and a proportional decrease of total elbow arthroplasties was detected. There were 18 revisions (4%), and 26 patients (6%) experienced an adverse event, of whom 16 (4%) required surgery. The completeness of the Swedish Elbow Arthroplasty Register regarding primary arthroplasty was 81%.

Conclusion

Primary arthroplasty as treatment of distal humeral fractures produces reliable results with regards to revisions and other adverse events.

Place, publisher, year, edition, pages
Philadelphia, PA, United States: Mosby, Inc. , 2019. Vol. 28, no 4, p. E104-E110
Keywords [en]
Elbow; fracture; distal humerus; arthroplasty; survival; register
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:liu:diva-155917DOI: 10.1016/j.jse.2018.07.035ISI: 000461354500002PubMedID: 30342824Scopus ID: 2-s2.0-85054832097OAI: oai:DiVA.org:liu-155917DiVA, id: diva2:1301556
Available from: 2019-04-02 Created: 2019-04-02 Last updated: 2019-04-10Bibliographically approved

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Nestorson, Jens

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Nestorson, JensAdolfsson, Lars
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Orthopaedics in Linköping
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Journal of shoulder and elbow surgery
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