Hemiarthroplasty for Traumatic Distal Humeral Fractures: A Systematic Review of the Literature Regarding Outcomes and Complications

Abstract

Aim: Distal humeral hemiarthroplasty (DHH) is a newer approach to the management of intra-articular distal humeral fractures and several studies have shown impressive functional outcomes, including no restriction in weightlifting, which is the most noticeable advantage compared to total elbow hemiarthroplasty (TEA). This review aims to summarize the reported functional outcomes and complications of DHH and compare them to those reported for both TEA and open reduction internal fixation (ORIF). Method(s): A review of the PubMed, Embase, and Scopus databases was performed. The search terms included distal humeral fracture' OR elbow fracture AND hemiarthroplasty' OR arthroplasty OR Replacement . Studies were limited to English publications with reported functional outcome measures and complications. Patient demographic characteristics, clinical outcomes including rangeof motion, outcome performance scores including [Mayo Elbow Performance Score (MEPS) and disabilities of the arm, shoulder and hand (DASH)] and complications were extracted. Result(s): Sixteen studies met the inclusion criteria. The age ranged from 53 to 88, and the mean length of follow-up ranged from 12 to 115 months postoperatively. The mean MEPS was 86.9, and the weighted mean supination/pronation arc was 165 degrees. The rate of complications was 7% for ulnar nerve irritation, 8% for stiffness, and 2% for revision to TEA. Conclusion(s): Based on current reported evidence, DHH appears to be a viable option to treat certain intra-articular distal humerus fractures. Reported case series suggest that, compared to ORIF and TEA, DHH may have fewer complications and is associated with low revision rates.