title: Outcomes of distal humerus fractures in patients above 65 years of age treated by plate fixation.
abstract: BACKGROUND
  Distal humerus fractures in elderly patients are often complex fractures that are difficult to treat. The goal of this study was to report on the results of a multicentre series of internal fixation of AO type A, B and C distal humerus fractures in elderly patients and to identify the pros and cons of various fixation constructs.
  
  
  METHODS
  Two studies were performed. One was a prospective multicentre study with 53 patients and the other was a retrospective multicentre study with 289 patients, all above 65 years of age and with a recent distal humerus fracture. Patients were evaluated based on clinical criteria (history, health condition, joint range of motion, Mayo Elbow Performance Score) and radiological criteria (fracture type, union of fracture, presence of malunion, hardware condition).
  
  
  RESULTS
  Based on the MEPS, the clinical and functional results were relatively satisfactory: average of 92 points for type A, 82 points for type B and 88 points for type C. In both series, type B fractures were the most difficult to treat and had less good clinical, functional and radiological outcomes. Most of the complications occurred with type C fractures; these consisted mainly of nerve injuries and fixation failure/non-union.
  
  
  CONCLUSIONS
  Although these fractures are difficult to treat and have an appreciable number of complications, the functional recovery was fairly satisfactory. One of the most challenging aspects of surgical treatment is the existence of osteoporosis in these patients. This must be carefully analysed to determine if an indication exists for total elbow arthroplasty.
  
  
  METHODS
  IV.
authors.affiliation: Service d'orthopédie-traumatologie, CHU de Strasbourg, avenue Baumann, 67400 Illkirch, France. Electronic address: phillipe.clavert@chru-strasbourg.fr.
authors.forename: P
authors.initials: P
authors.lastname: Clavert
authors.forename: G
authors.initials: G
authors.lastname: Ducrot
authors.forename: F
authors.initials: F
authors.lastname: Sirveaux
authors.forename: T
authors.initials: T
authors.lastname: Fabre
authors.forename: P
authors.initials: P
authors.lastname: Mansat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Elderly; Humeral distal fracture; Locked compression plate; Osteosynthesis