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

Clinics in Shoulder and Elbow 2020년 23권 2호 p.94 ~ 99
백종석, 이성현, 강현탁, Song Tae-Hyun, 김정우,
소속 상세정보
백종석 ( Baik Jong-Seok ) - Wonkwang University School of Medicine Wonkwang University Hospital Department of Orthopaedic Surgery
이성현 ( Lee Sung-Hyun ) - Wonkwang University School of Medicine Wonkwang University Hospital Department of Orthopaedic Surgery
강현탁 ( Kang Hyun-Tak ) - Wonkwang University School of Medicine Wonkwang University Hospital Department of Orthopaedic Surgery
 ( Song Tae-Hyun ) - Wonkwang University School of Medicine Wonkwang University Hospital Department of Orthopaedic Surgery
김정우 ( Kim Jeong-Woo ) - Wonkwang University School of Medicine Wonkwang University Hospital Department of Orthopaedic Surgery

Abstract


Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and 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.

키워드

Fracture fixation; Total elbow replacement; Humeral fracture; Aged,65 and over; Treatment outcomee

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