TY  - JOUR
A1  - Mühlenfeld, Nils
A1  - Marzi, Ingo
A1  - Frank, Johannes
T1  - Total elbow arthroplasty in elderly trauma patients: adding a new perspective for functional evaluation
T2  - European journal of trauma and emergency surgery
N2  - Purpose: Total elbow arthroplasty (TEA) has evolved over the last years, with satisfactory early results, mainly not only in degenerative arthritis, but also increasingly after trauma. Outcome studies in recently published papers are mainly based on the range of motion (ROM), complication rate as well as patient-reported outcome scales and questionnaires. The purpose of this study was to add a new perspective with the “Purdue Pegboard” skill tests in a homogenous set of elderly trauma patients to contribute to a more precise objective outcome measurement in this specific population.
Methods: A retrospective review was performed on a consecutive cohort of all patients with age above 60 years that received TEA after trauma. Data from follow-up examinations over a standardized time-schedule within 2 years after TEA were included. Mayo Elbow Performance Score (MEPS), “Disability of Arm, Shoulder and Hand” (DASH) Questionnaire, ROM as well as test-scores using the Pegboard test were evaluated.
Results: Mean age was 76.0 years ± 10.3. Indications for TEA were posttraumatic arthrosis in 68.8% (n = 11) and extensive fractures that could not be reconstructed surgically in 31.3% (n = 5). The mean score of MEPS was 82.81 ± 16.63 and 29.18 ± 12.01 in the DASH. ROM presented with a mean of 109.7° ± 15.4. Patients demonstrated good, but marginally reduced test scores in the Pegboard skill tests in comparison with the healthy reference population. No relevant differences between the arm with and the arm without TEA (0.3 ± 3.6; p = 0.715) were noted after 2 years.
Conclusion: In the elderly trauma patient with complex fractures of the elbow, TEA is a good alternative to joint reconstruction using various osteosynthesis techniques. TEA is able to avoid revision surgery after open reduction and internal fixation of complex fractures. In cases of failed reconstruction, it is also a viable secondary procedure in posttraumatic arthrosis. Good outcomes in functionality and dexterity can be achieved. Skill tests like the Purdue Pegboard could add a valuable perspective in assessing functional outcomes after TEA.
KW  - Total elbow arthroplasty
KW  - Purdue Pegboard
KW  - Elderly trauma patient
KW  - Dexterity
KW  - Complex elbow fractures
KW  - Follow-ups
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69620
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-696209
SN  - 1863-9941
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 48
IS  - 5
SP  - 3941
EP  - 3947
PB  - Springer Medizin
CY  - Heidelberg
ER  -