TY - JOUR

T1 - Good functional outcomes after open reduction and internal fixation for AO/OTA type 13-C2 and-C3 acute distal humeral fractures in patients aged over 45 years

AU - Al-Hamdani, Ali

AU - Rasmussen, Jeppe V.

AU - Olsen, Bo S.

PY - 2022

Y1 - 2022

N2 - Background: The purpose of this study was to report the functional outcomes and complications after open reduction and internal fixation (ORIF) for Arbeitsgemeinschaft fueuror Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) type 13-C2 and -C3 acute distal humeral fractures with minimum 2-year follow-up. Our hypothesis was that ORIF would provide functional outcomes that are comparable to those of total elbow arthroplasty and elbow hemiarthroplasty reported in the literature. Materials and methods: During a 6-year period, 23 patients aged > 45 years were treated with double plating for AO/OTA type 13-C2 or -C3 fractures. The mean age was 62 years (range, 46-80 years). The Oxford Elbow Score was used as the primary outcome; the Mayo Elbow Performance Score, pain severity score (on a visual analog scale), range of motion, reoperations, and complications were used as Results: The median Oxford Elbow Score was 42 (range, 25-48), where a score of 48 represents a normal elbow; 20 patients achieved good to excellent outcomes, and 3 achieved fair outcomes. The median Mayo Elbow Performance Score was 85 (range, 60-100), where a score of 100 represents a normal elbow; 18 patients achieved good to excellent outcomes, and 5 achieved fair outcomes. The median visual analog scale score was 2 (range, 0-5). The median flexion-extension and supination-pronation arcs were 120 degrees (range, 70 degrees-155 degrees) and 160 degrees (range, 75 degrees-170 degrees), respectively. Eight complications were recorded in 7 patients; 4 of them required reoperation because of fracture pseudarthrosis or elbow stiffness. Ten patients were working at the time of trauma, and nine of them returned to the same occupation. Our results are comparable to the results of previously published studies regarding the outcome of ORIF, elbow hemiarthroplasty, or total elbow arthroplasty for AO/OTA type 13-C fractures. Conclusion: ORIF is a reliable treatment option for AO/OTA type 13-C2 and -C3 acute distal humeral fractures in middle-aged and elderly patients, despite the considerable rate of complications. Good to excellent results can be obtained in most patients. (c) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

AB - Background: The purpose of this study was to report the functional outcomes and complications after open reduction and internal fixation (ORIF) for Arbeitsgemeinschaft fueuror Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) type 13-C2 and -C3 acute distal humeral fractures with minimum 2-year follow-up. Our hypothesis was that ORIF would provide functional outcomes that are comparable to those of total elbow arthroplasty and elbow hemiarthroplasty reported in the literature. Materials and methods: During a 6-year period, 23 patients aged > 45 years were treated with double plating for AO/OTA type 13-C2 or -C3 fractures. The mean age was 62 years (range, 46-80 years). The Oxford Elbow Score was used as the primary outcome; the Mayo Elbow Performance Score, pain severity score (on a visual analog scale), range of motion, reoperations, and complications were used as Results: The median Oxford Elbow Score was 42 (range, 25-48), where a score of 48 represents a normal elbow; 20 patients achieved good to excellent outcomes, and 3 achieved fair outcomes. The median Mayo Elbow Performance Score was 85 (range, 60-100), where a score of 100 represents a normal elbow; 18 patients achieved good to excellent outcomes, and 5 achieved fair outcomes. The median visual analog scale score was 2 (range, 0-5). The median flexion-extension and supination-pronation arcs were 120 degrees (range, 70 degrees-155 degrees) and 160 degrees (range, 75 degrees-170 degrees), respectively. Eight complications were recorded in 7 patients; 4 of them required reoperation because of fracture pseudarthrosis or elbow stiffness. Ten patients were working at the time of trauma, and nine of them returned to the same occupation. Our results are comparable to the results of previously published studies regarding the outcome of ORIF, elbow hemiarthroplasty, or total elbow arthroplasty for AO/OTA type 13-C fractures. Conclusion: ORIF is a reliable treatment option for AO/OTA type 13-C2 and -C3 acute distal humeral fractures in middle-aged and elderly patients, despite the considerable rate of complications. Good to excellent results can be obtained in most patients. (c) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

KW - Elbow

KW - Plating

KW - ORIF

KW - Humerus

KW - Fracture

KW - Outcome

KW - Reoperation

KW - Complication

KW - TOTAL ELBOW ARTHROPLASTY

KW - COMPLEX FRACTURES

KW - HEMIARTHROPLASTY

KW - MANAGEMENT

KW - SCORE

U2 - 10.1016/j.jse.2021.07.024

DO - 10.1016/j.jse.2021.07.024

M3 - Journal article

C2 - 34474137

VL - 31

SP - 143

EP - 150

JO - Journal of Shoulder and Elbow Surgery

JF - Journal of Shoulder and Elbow Surgery

SN - 1058-2746

IS - 1

ER -