Mid-term outcome of elbow hemiarthroplasty performed in a tertiary elbow hub

Elbow hemiarthroplasty (EHA) is a surgical option for managing acute, non-reconstructable distal humerus fractures in elderly and low-demand patients. In England, due to its low-volume nature, EHA is now centralised to designated regional hubs. This study evaluates medium-term clinical and radiological outcomes of EHA performed in a high-volume tertiary elbow hub.

A retrospective review of consecutive patients treated with EHA for acute distal humeral fracture between 2016 and 2024 was performed. Clinical and radiological outcomes were assessed, and all complications and re-operations were documented. Subgroup analysis compared outcomes for tertiary versus local referrals and for patients aged <80 versus ≥80 years.

Fifty-five patients, including 50 (91%) females with a mean age of 75 (57-93), were included. Median time to surgery was 8 days (6-12). Thirty cases (55%) were external referrals. Clinical outcome data were available for 44 patients. Mean follow-up was 44 months (13-101). Median Oxford Elbow Score 44 (40-46) and visual analogue scale 1 (0-2), with a mean flexion arc of 123° (70°-140°). The overall complication rate was 16%, with a 4% re-operation rate (2 patients). No cases of implant loosening or instability were recorded, and no cases required revision surgery.

Centralised EHA for acute distal humeral trauma demonstrates consistent, good clinical outcomes and a favourable complication profile when compared to the literature and national registry data. These findings support the centralisation of low-volume arthroplasty to hub units.