Custom-made endoprosthetic reconstruction of the distal humerus for non-tumorous pathology

Eight patients underwent custom-made endoprosthetic elbow reconstruction between 1989 and 2006 either for failed primary total elbow replacements or following complex fracture complications. A functional assessment using the Toronto Extremity Salvage (TES) score was performed. Patients were followed for a mean of 46.1 months (range : 25 to 88). One patient who presented with an infected periprosthetic fracture around a total elbow replacement, failed two-stage reconstruction and underwent excision arthroplasty. The remaining seven patients were available for functional follow-up. Average flexion deformity was 15 degrees (range: 7 to 35) and average flexion arc was 85 degrees (range : 70 to 130). The mean TES score was 67.3 (range: 36.6 to 95.9). Custom made endoprosthetic reconstruction allowed for a satisfactory outcome in all but one of these eight patients with severe bony destruction around the elbow in the absence of tumour infiltration.