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Hemiarthroplasty for Distal Humerus Fracture: A Systematic Review and Meta-analysis for Functional Outcome
Clinics in Shoulder and Elbow 2018;21:120-126
Published online September 1, 2018
© 2018 Korean Shoulder and Elbow Society.

Jae-Man Kwak1, Erica Kholinne1,2, Yucheng Sun1, Gwan Bum Lee1, Kyoung Hwan Koh1, Jae-Myeung Chun3, In-Ho Jeon1

1Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, 2Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia, 3Department of Orthopaedic Surgery, Armed Forces Capital Hospital, Seongnam, Korea
Correspondence to: In-Ho Jeon
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-3896, Fax: +82-2-488-7877, E-mail: jeonchoi@gmail.com, ORCID: https://orcid.org/0000-0002-9289-9193
Received May 29, 2018; Accepted July 8, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures.
Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 쁡istal humerus fracture and 쁥emiarthroplasty. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed.
Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion (107.6째 flexion-extension, 157.5째 for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range.
Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.
Keywords : Hemiarthroplasty; Humerus; Elbow; Fracture; Meta analysis