We report the cases of two patients who required total elbow arthroplasty (TEA) for nonunion of a distal humerus fracture. The first patient was an 86-year-old woman with a distal humerus fracture. Because the fracture was not displaced, she was treated conservatively. After 3 months, the fracture had not healed, so we performed open reduction internal fixation (ORIF) with tension band wiring. Six months after this operation, the nonunion had not healed, so we performed ORIF using a Mayo plate and bone graft. No improvement was observed 19 months after the procedure, and TEA was performed with a Coonrad-Morrey prosthesis. Sixteen months after TEA, the Japanese Orthopedic Association (JOA) score was 79 points, and the patient was satisfied with the result. The second patient was a 65-year-old woman with fractures of the distal end and shaft of the humerus. She had been diagnosed with rheumatoid arthritis at the age of 52 years. Because the fracture seemed to be displaced, we performed surgery using a locking compression plate. Nine months after the surgery, the plate broke, and the fracture had not healed. Therefore, we preformed TEA with a Coonrad-Morrey prosthesis. After 12 months, the JOA score was 77 points, and the patient was satisfied with the result.
