Abstract：
Intra-articular distal humerus fractures present various challenges with a wide array of treatment options. Open reduction internal fixation remains the treatment of choice. In older patient populations with poor bone quality and short-end segment fractures with articular comminution, open reduction internal fixation, however, may bring on unsurmountable technical challenges. Total elbow arthroplasty and elbow hemiarthroplasty (EHA) may offer superior functional outcomes in these cases. During EHA for fractures, the medial and lateral columns are reconstructed with the collateral ligaments to restore elbow stability. We hypothesize that in coronal sheer fracture patterns where the columns are intact, maintaining the native collateral ligaments and columns will provide both an anatomic and stable elbow joint. We introduce the ligament sparing EHA technique for unreconstructible coronal shear fractures. We describe this novel technique and compare our postoperative outcomes in 2 patients who underwent this surgery to those described in the literature. The postoperative Disabilities of the Arm, Shoulder, and Hand scores for the 2 patients were 13.8 and 10.3, respectively. The Mayo Elbow Performance Score for the 2 patients were 80 and 85, respectively. The operative arm presented a grip strength of 82% and 89% when compared with the contralateral arm, for the patients respectively. The range of motion varied between 78% and 100% of the contralateral arm for both patients. Although our results are promising and the ligament sparing EHA technique may be a more anatomic option in certain fracture patterns, further research with larger cohorts and multiple surgeons is needed to reinforce our results.
摘要：
肱骨远端关节内骨折提出了各种挑战，具有广泛的治疗选择。切开复位内固定仍然是首选治疗方法。在骨质量差和短节段骨折伴关节粉碎性的老年患者中，切开复位内固定,然而,可能会带来无法克服的技术挑战。在这些情况下，全肘关节置换术和肘关节置换术（EHA）可能会提供出色的功能结果。在EHA骨折期间，内侧和外侧柱用副韧带重建，以恢复肘部的稳定性。我们假设在柱子完好无损的日冕断裂模式中，保持天然的副韧带和柱子将提供解剖和稳定的肘关节。我们介绍了保留韧带的EHA技术，用于不可重建的冠状剪切骨折。我们描述了这项新技术，并将接受该手术的2例患者的术后结果与文献中描述的结果进行了比较。手臂的术后残疾，肩膀,2例患者的Hand评分分别为13.8和10.3。2例患者的Mayo肘关节性能评分分别为80分和85分。与对侧臂相比，手术臂的握力分别为82％和89％。分别为患者。两名患者的运动范围在对侧臂的78％至100％之间变化。尽管我们的结果很有希望，并且保留韧带的EHA技术在某些骨折模式中可能是更多的解剖选择，需要对更大的队列和多名外科医生进行进一步的研究,以加强我们的结果.
