title: A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65.
abstract: OBJECTIVE
  To compare open reduction and internal fixation (ORIF) with total elbow arthroplasty (TEA) for intraarticular distal humerus fractures in women older than 65 years of age.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Information was obtained from a Level 1 trauma center with fellowship-trained traumatologists and a tertiary care center with fellowship-trained shoulder and elbow surgeons.
  
  
  METHODS
  Patients were 24 women older than age 65 who sustained distal humerus fractures that required surgical treatment with clinical follow-up at a minimum of 2 years. All fractures were OTA classification 13.C2 or 13.C3. No patients were lost to follow-up.
  
  
  METHODS
  ORIF or TEA was the treatment method.
  
  
  METHODS
  The Mayo Elbow Performance score and the need for revision surgery were established as the means of patient evaluation.
  
  
  CONCLUSIONS
  Using the Mayo Elbow Performance score, the outcomes of the 12 patients treated with ORIF were as follows: 4 excellent, 4 good, 1 fair, and 3 poor (cases that required conversion to TEA). Outcomes of the 12 patients treated with TEA were as follows: 11 excellent and 1 good. There were no fair or poor outcomes in the TEA group. No patients treated with TEA required revision surgery. We believe TEA to be a viable treatment option for distal intraarticular humerus fractures in women older than age 65. This is particularly true for women with associated comorbidities, such as rheumatoid arthritis, osteoporosis, and conditions requiring the use of systemic steroids.
authors.affiliation: Florida Orthopaedic Institute, 4175 East Fowler Avenue, Tampa, FL 33617, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frankle
authors.forename: Dolfi
authors.initials: D
authors.lastname: Herscovici
authors.forename: Thomas G
authors.initials: TG
authors.lastname: DiPasquale
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Vasey
authors.forename: Roy W
authors.initials: RW
authors.lastname: Sanders
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome