[Long-term results of therapy of open and closed fractures of the elbow joint].
Fractures of the elbow joint are quite rare compared with the total incidence of injuries to the extremities. However, elbow fractures often result in significant disability. Therefore in a retrospective study, we have evaluated criteria that are of prognostic value for late functional outcome. Sixty-four (10.3%) of 622 patients with closed elbow fractures and 107 (89%) of 119 patients with open elbow fractures underwent a physical examination. The mean follow-up time was 8.2 years. The functional outcome was recorded by a modified score (0-max. 15) according to Morrey. Epidemiological data from both groups revealed a greater severity and higher degree of injury in open fractures than in closed fractures. In contrast, both groups presented a comparably good functional result. The most significant factor for poor outcome (score < 5) was identified as nerve lesions. Among all nerve lesions in open fractures, 45% resulted in a functional score of < 5; in 42% of closed fractures combined with a nerve lesion a similarly poor result was also noted. A second major factor appeared to be the method of primary therapy. An external joint transfixation resulted in a score of < 5 in 32% of patients that were treated primarily by transfixation. In cases initially treated with open reduction and internal fixation, only 18.5% of open fractures and 3.1% of closed fractures presented a similar low score. According to our results the late functional outcome of elbow fractures depends less on the type of fracture than on the presence of a nerve lesion and the method of primary treatment, which should facilitate early mobilization.
Seekamp
A
A
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Regel
G
G
Blauth
M
M
Klages
U
U
Klemme
R
R
Tscherne
H
H
D004551:Elbow Joint / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology*; D005596:Fractures, Closed / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D011885:Radius Fractures / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery; D000092464:Elbow Injuries