Αττικό Νοσοκομείο
- Introduction: Distal humeral fractures are uncommon (only 1–2% of fractures). However in the elderly(>70 years) are on the rise. Treatment for this population remains a challenge due to complexity, poor bone quality and osteoporosis and severe comorbidities. Regarding operative treatment a controversy remains in the literature: ORIF versus Total Elbow Arthroplasty (TEA).
- Aim of this study is to assess the functional, radiological outcomes and complications of patients aged > 70 years treated with ORIF for distal humerus fractures and to assess whether ORIF achieves adequate results even in elderly patients.
- Materials and Methods: 31 patients (25 females,6 males) were included in the study and data were collected in our institution from 2012 until 2020. Mean age of the population was 78 years (range: 71-87). Fractures were classified according to AO and Gustilo–Anderson classification. Patients were evaluated based on :joint range of motion, complications, radiological evaluation and Mayo Elbow Performance Score (MEPS).
- Results: mean follow-up period was 3.4 years (range 1 - 7 yrs). Average ROM: average flexion 127° (range 100°-150°), average loss of extension of 20.9° (range 5°- 40°),average pronation 68.3° (range 0°- 90°),average supination 75.3° (range 0°- 90°), average MEPS: 88.7 (range 60- 100). Seven patients had nonunion but only one patient needed a revision surgery with ORIF and bone graft. Six patients did not have significant effect on the clinical outcome and no patient had infection.
- Conclusions: ORIF of distal humerus fractures is a reliable treatment option even in the elderly (> 70 yrs) with good to excellent outcomes with low complication and revision rate. In Elderly with a massive osteoporosis & comminuted low fractures, we should consider TEA as a reliable treatment modality. However, advanced age should not be a contraindication to ORIF of distal humerus fractures and we should evaluate the “biological age” of the patient & not the absolute numbers.
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Abstract ID
AA188
