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.
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.
Frankle
Mark A
MA
Florida Orthopaedic Institute, 4175 East Fowler Avenue, Tampa, FL 33617, USA.
Herscovici
Dolfi
D
DiPasquale
Thomas G
TG
Vasey
Matthew B
MB
Sanders
Roy W
RW
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