Abstract
Managing fractures of distal humerus in patients with rheumatoid arthritis (RA) is technically challenging. Total elbow arthroplasty (TEA) is one of the treatment options for these fractures. While elbow motion is largely regained by TEA, comminuted condyle fragments are often ignored. Although numerous approaches for repair of condylar fragments around TEA are described, any universal fixation strategy for these fractures has not been established. This report describes, for the first time, application of an ultra-high molecular weight polyethylene (UHMWPE) tape for the treatment of distal humerus fracture in 2 patients with rheumatic elbow arthropathy. The post-operative clinical courses were good. Radiographs showed bony union of the condylar fragments without loosening in two cases. Because of its flat configuration, softness, and flexibility, UHMWPE tape is a promising material for stabilizing fracture of the distal humerus associated with TEA.
Highlights
Managing fractures of distal humerus in patients with rheumatoid arthritis (RA) is technically challenging as the articular surface should be reconstructed for joint function while the muscular origins on the condyle are retained for functional elbow and wrist movement
Numerous approaches for repair of distal humerus fracture around Total elbow arthroplasty (TEA) were described in the literatures, complications such as breakage, back out, migration, irritation of the fixation materials, nonunion, and bursitis had been reported
We describe, for the first time, fractures of the distal humerus around TEA are successfully managed by using ultra-high molecular weight polyethylene (UHMWPE) tape (NESPLON Cable System, Alfresa Pharma Corporation, Osaka, Japan) in 2 patients with rheumatic elbow arthropathy, and review literatures
Summary
Managing fractures of distal humerus in patients with rheumatoid arthritis (RA) is technically challenging as the articular surface should be reconstructed for joint function while the muscular origins on the condyle are retained for functional elbow and wrist movement. Total elbow arthroplasty (TEA) is one of the treatment options for these fractures [1]-[4]. Numerous approaches for repair of distal humerus fracture around TEA were described in the literatures, complications such as breakage, back out, migration, irritation of the fixation materials, nonunion, and bursitis had been reported. We describe, for the first time, fractures of the distal humerus around TEA are successfully managed by using ultra-high molecular weight polyethylene (UHMWPE) tape (NESPLON Cable System, Alfresa Pharma Corporation, Osaka, Japan) in 2 patients with rheumatic elbow arthropathy, and review literatures
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