Fractures

The rate of periprosthetic fractures after elbow arthroplasty vary from 6% to 22%.20, 21, 22 The prevalence is expected to rise as the complexity and frequency of primary and revision elbow replacements increase.

Periprosthetic fractures following total elbow replacement may be classified use the Mayo classification and the Vancouver classification of periprosthetic fractures after total hip arthroplasty as guidelines.23, 24 Fractures are classified according to location, bone quality and whether or not stable fixation of the component is preserved. Classification of the humerus and ulna are determined separately.

In a Type 1 periprosthetic fracture, the fracture occurs in the metphyseal region of the distal humerus and proximal ulna without loosening. In Typ2, the fracture occurs in the diaphyseal portion of the bone prosthesis composite, and the component is usually loose. Type 2 is sub classified into A and B; A is for good bone quality, and B for poor bone quality. In Type 3, the fracture involves the diaphysis but is not related to the prosthesis, i.e. proximal to the humeral component and distal to the ulnar component.

Mayo classification of periprosthetic fractures after elbow arthroplasty.

Type 2B periprosthetic fracture. The ulna had poor bone quality secondary to chronic infection.

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