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Distal Humerus Fracture in 73F
HPI
A 73-year-old female suffered a ground-level fall. At the time of the fall she was living independently. She denies antecedent elbow pain.
PMH
Her past medical history is significant for hypertension and atrial fibrillation. She is currently on anticoagulation.
PE
On physical exam, she has a BMI 48. Examination of the elbow shows swelling of the elbow with intact skin and no significant abrasions. She is unable to flex and extend the elbow secondary to pain. A neurological exam shows she had no deficits distal to the elbow. Her vascular exam is normal.
Total Elbow Arthroplasty for Acute Fracture. Decision made preoperatively to avoid olecranon osteotomy. On the humerus a long stem was used given fracture (allows long flange). A modification was made to add a slight bend in sagittal plane to keep in bone. TEA indicated given age, comminution of fracture site - Particularly low intraarticular nature, with difficulty salvaging intraarticular segments
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