Immediate Total Elbow Arthroplasty Following Olecranon Osteotomy: A Case Report

Consistent with an aging population, the overall number of distal humeral fractures in the elderly is increasing. Indications for application of acute total elbow arthroplasty (TEA) in the setting of distal humeral fractures are still being defined. A variety of factors including chronologic age, physiologic age, bone quality, presence of pre-existing arthritis and pre-existing medical conditions need to be considered. Optimally the decision to proceed with TEA verses open reduction internal fixation (ORIF) is made preoperatively. The need to abandon ORIF may be not be apparent until after fracture exposure, and the presence of an olecranon osteotomy makes performing TEA challenging. A case is presented of acute conversion from ORIF to TEA following olecranon osteotomy, utilizing internal fixation bridging the ulnar component and its cement mantle.