There are two options for arthroplasty when treating a distal humeral fracture:
Elbow arthroplasty is a challenging decision-making process and procedure which requires experience in arthroplasty and managing related complications.
A total elbow arthroplasty performed for fractures is an inherently stable construct as the humeral and ulnar components are linked.
A potential disadvantage of this technique is the risk of stem loosening because of load transfer to the stem-cement-bone interface and polyethylene wear at the implant linkage.
In case of preexisting elbow arthritis or in a patient with associated unreconstructable osseous or ligamentous instability lesions, a total elbow arthroplasty should be considered.
Hemiarthroplasty is an unlinked articulation.
Joint stability in this technique is reliant on anatomical repair of the native collateral ligaments around the implant.
Potential disadvantages of this technique are joint instability and wear of the native olecranon and radial head.
The general indications for hemiarthroplasty are the same as for total elbow arthroplasty.
Specific indications for hemiarthroplasty