SEMICONSTRAINED ELBOW REPLACEMENT FOR DISTAL HUMERAL NONUNION

We have reviewed 36 of 39 consecutive patients with an average age of 68 years who had semiconstrained elbow replacement for distal humeral nonunion at an average follow-up of 50.4 months (24 to 127). Of these, 31 (86%) had satisfactory results, three (8%) had fair, and two (6%) had poor results; 32 patients (88%) had moderate or severe pain before and 91% had no or only mild discomfort after the procedure. Motion ha d improved from a mean are of 29 degrees to 103 degrees before operati on to 16 degrees to 127 degrees after surgery. All five flail extremit ies were stable at last assessment. There were seven complications (18 %): two patients had deep infection, two had particulate synovitis, tw o had ulnar neuropathy and one had worn polyethylene hushes, Five of t hese seven, excluding the two with transient neuropathy, required reop eration (13%). Joint replacement arthroplasty can be a safe and reliab le treatment for this difficult clinical condition, seen most commonly in elderly patients. This is a significant advance, since repeated os teosynthesis has been shown to be ineffective in most patients.