Symposium

Semi-constrained elbow prostheses were also used for 49 trauma victims, mostly women (81.25%). The sexratio was 4.33:1. Mean age at surgery was 69.77 years. Two types of prostheses were used: Coonrad-Morrey for from three to five years, the elbows were totally or nearly totally pain free with joint motion near 100°. The elbows were stable (except with G1 prostheses) with satisfactory function of the homolateral upper limb. The Mayo Clinic total score varied from 71 points for G1 prostheses to 93 for Coonrad-Morrey prostheses. Good or excellent outcome was reported for 68% of the Kudo prostheses and 100% of the G3 prostheses. Radiologically, lucent lines were often limited to a single zone. Humeral lines were 45 patients and GSBIII for four. Indications were: recent fractures of the distal humerus (n = 21), nonunion of the humeral palette (n = 10), posttraumatic degenerative disease (n = 12), chronic instability (n = 6). Two groups were analyzed: group 1 included patients treated for recent fracture and nonunion (n = 31 elbows) and group 2 patients treated for posttraumatic degenerative disease with chronic instability (n = 18 elbows). At mean followup of 17.4 months, outcome in group 1 (Mayo Clinic score) was excellent or good in 80%. The total Mayo Clinic score was 82.5 points and the DASH score was 55 points. Five complications (16%) were noted in this group, with surgical revision required for three patients (10%). In this group none of the implants were replaced. In group 2, mean follow- up was two years and the results were considered excellent or good in 77%. The total Mayo Clinic score was 75.3 points, and the DASH score 46.7 points. Nine patients (50%) presented complications, five leading to revision (28%). There was one failure due to disassembly of a GSBIII implant which was replaced. For trauma victims, the Coonrad-Morrey implant appears to be a reliable therapeutic solution for selected patients providing a high level of patient satisfaction when other options have to be ruled out. With this technique, patients recover a pain-free elbow with satisfactory joint motion.