Outcomes of distal humerus fractures in patients above 65 years of age treated by plate fixation

被引:41
作者
Clavert, P. [1 ]
Ducrot, G. [1 ]
Sirveaux, F. [2 ]
Fabre, T. [3 ]
Mansat, P. [4 ]
机构
[1] CHU Strasbourg, Serv Orthopedie Traumatol, F-67400 Illkirch Graffenstaden, France
[2] Ctr Chirurg Emile Galle, Serv Orthopedie Traumatol, F-54000 Nancy, France
[3] Hop Pellegrin, Serv Orthopedie Traumatol, F-33076 Bordeaux, France
[4] CHU Toulouse, Inst Appareil Locomoteur, F-31059 Toulouse, France
[5] Soc Francaise Chirurg Orthoped & Traumatol, F-75014 Paris, France
关键词
Humeral distal fracture; Osteosynthesis; Elderly; Locked compression plate; TOTAL ELBOW ARTHROPLASTY; INTERNAL-FIXATION; OPEN REDUCTION; INTERCONDYLAR FRACTURES; OPERATIVE TREATMENT; ELDERLY-PATIENTS;
D O I
10.1016/j.otsr.2013.08.001
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Introduction: 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. Patients and 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. Discussion: 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. Level of evidence: IV. (C) 2013 Published by Elsevier Masson SAS.
引用
收藏
页码:771 / 777
页数:7
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