Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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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

  • Baik, Jong Seok (Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Lee, Sung Hyun (Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Kang, Hyun Tak (Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Song, Tae Hyun (Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Kim, Jeong Woo (Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine)
  • 투고 : 2020.01.31
  • 심사 : 2020.03.22
  • 발행 : 2020.06.01
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초록

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.

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참고문헌

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피인용 문헌

  1. Is total elbow arthroplasty a reliable alternative treatment option for comminuted distal humerus fractures in elderly patients? vol.23, pp.2, 2020, https://doi.org/10.5397/cise.2020.00157
  2. 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 vol.31, pp.1, 2020, https://doi.org/10.1016/j.jse.2021.07.024