抄録
Introduction: Distal humeral hemiarthroplasty (DHH) is an attractive treatment option to address concerns about the potential for complications associated with the presence of polyethylene or an ulnar component following total elbow arthroplasty. However, there are very few accounts in the literature regarding DHH outcomes when Japanese manufactured prostheses have been used. We report about early- to mid-term results in three cases of humeral hemiarthroplasty.
Case 1: A 32-year-old patient with rheumatoid arthritis with a bony ankylosis of the elbow and with 30 degrees of extension, underwent DHH treatment using the Osaka University Model Elbow System, (MMT Co., Ltd., Japan). At four years follow-up, the preoperative Japan Orthopedic Association (JOA) score of 47 improved to 96 points, and the flexion and extension range of motion (ROM) improved to 136 and 8 degrees, respectively. Radiologically, there were no radiolucent lines at the implant interface.
Case 2: A humeral supracondylar fracture in a 93-year-old female with a history of heart failure underwent DHH treatment using the Fine Elbow System (Nakashima Medical Co., Ltd., Japan). However, the patient died from an exacerbation of cardiac failure at three months postoperatively. Flexion and extension ROM was 110 and 30 degrees, respectively at the last follow-up. There were no radiological complications in the elbow, and bone fusion was confirmed in the osteotomized area of the olecranon used for the surgical approach.
Case 3: DHH was performed for a distal humeral comminuted fracture in a 76-year-old female using the Fine Elbow System. At the 1-year follow-up, the JOA score was 89 points and the flexion and extension ROM was 120 and 10 degrees, respectively. There were no radiological signs of implant protrusion into the ulna.
Discussion: This short- and mid-term review suggests that DHH may be an effective treatment for selected elbow disease. However, DHH should be used with caution until studies of long-term outcome demonstrate its efficacy.
