Distal Humerus-Internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients

Internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients

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This study compared the outcomes of elderly patients with displaced intra-articular, distal humeral fractures who were treated with either open reduction internal fixation (ORIF) or total elbow arthroplasty (TEA). The study found that TEA resulted in more predictable and improved functional outcomes compared to ORIF at the 2-year follow-up. Patients who underwent TEA had significantly better Mayo Elbow Performance Scores (MEPS) at 3 months, 6 months, 12 months, and 2 years compared to the ORIF group. TEA also resulted in better Disabilities of the Arm, Shoulder and Hand (DASH) scores at 6 weeks and 6 months. The mean operative time was 32 minutes shorter for TEA. The reoperation rates for TEA and ORIF were not statistically different. However, 25% of fractures randomized to ORIF were not amenable to internal fixation and were converted to TEA intraoperatively. The study concluded that for elderly patients with complex distal humeral fractures that are not amenable to stable fixation, TEA is a preferred alternative to ORIF.

Keywords

elderly patients

displaced intra-articular fractures

distal humeral fractures

open reduction internal fixation

total elbow arthroplasty

functional outcomes

Mayo Elbow Performance Scores

Disabilities of the Arm, Shoulder and Hand scores

operative time

reoperation rates