Clin Should Elbow.  2020 Jun;23(2):94-99. 10.5397/cise.2020.00052.

Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

• Jong Seok B
• Sung Hyun L
• Kang HT
• Song TH
• Kim JW

• KMID: 2502782
• DOI: http://doi.org/10.5397/cise.2020.00052

Abstract

Background
Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older.
Methods
Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit.
Results
The ORIF and TEA groups showed a mean arc of flexion–extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups.
Conclusions
In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

Keyword

Open reduction and internal fixation; Total elbow arthroplasty; Distal humerus fracture; Elderly; DASH score; MEPS