hemiarthroplasty

Displaced Arthroplasty

Indications

 

Patient > 70

 

Gjertsen et al JBJS Am 2010

- 4335 patients > 70 with displaced subcapital fractures

- minimum 1 year follow up

- 1 year mortality same in each group / 25%

- 22% reoperation in ORIF v 3% in hemiarthroplasty

- more pain / higher dissatisfaction / lower quality life in ORIF group

 

Options

 

Hemiarthroplasty

- unipolar monoblock

- unipolar modular

Distal Humerus Fractures

EpidemiologyDistal Humeral Fracture

 

2 groups

- young patient with high velocity injury

- older patient with comminuted, osteoporotic fracture

 

In the second group fixation can be very difficult

 

Anatomy

 

Hinged Joint

- trochlea axis is centre of rotation

- 40o anterior angulation in sagittal plane