Outcomes at mean follow-up of four years following AO type-C distal humerus fractures managed with fixation or arthroplasty.
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All Authors
Allen, J.
Budworth, L.
Cowling, P.
Tunstall, C.
Limb, D.
Vollans, S.
LTHT Author
Allen, James
Cowling, Paul
Tunstall, Charlotte
Limb, David
Vollans, Sam
Cowling, Paul
Tunstall, Charlotte
Limb, David
Vollans, Sam
LTHT Department
Trauma & Related Services
Orthopaedics
Orthopaedics
Non Medic
Publication Date
2025
Item Type
Journal Article
Language
Subject
Subject Headings
Abstract
Aim: To compare outcomes between open reduction internal fixation (ORIF), total elbow replacement (TER) and distal humerus hemiarthroplasty (DHH) for AO type-C (AOC) fractures of the distal humerus in patients aged 50 years or older.
Methods: A retrospective analysis of acute AOC distal humerus fractures in patients aged 50 years or older between 2016 and 2022. Outcomes measured: Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complication rate, re-operation rate and range of movement (ROM).
Results: Sixty-five patients met the inclusion criteria (20 males, 45 females). Mean age was 64.4, 77.1 and 61.3 years old for ORIF, TER and DHH respectively. Logistic model analysis revealed a statistically significant increased complication rate in the ORIF group compared to the TER and DHH groups (ORIF vs TER p = 0.01; ORIF vs DHH p = 0.048). There was a higher re-operation rate in the ORIF group compared to the DHH group (p = 0.03). There were no differences in OES, MEPS or ROM between groups.
Discussion: This supports the use of TER in elderly patients with AOC distal humerus fractures. In the younger patient, DHH may have lower rates of complications and re-operations compared to ORIF, but function remains similar. We propose a prospective randomised control trial.
Journal
Shoulder And Elbow