A multicenter, prospective, randomized, controlled trial of open reduction—internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients

McKee, Michael D.; Veillette, Christian; Hall, Jeremy A.; Schemitsch, Emil H.; Wild, Lisa M.; McCormack, Robert G.; Perey, Bertrand H.; Goetz, Thomas J.; Zomar, Mauri; Moon, Karyn; Mandel, Scott; Petit, Shirlet; Guy, Pierre; Leung, Irene

doi:10.1016/j.jse.2008.06.005

Cited by 427 publications

(256 citation statements)

References 25 publications

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“…Other studies demonstrated postoperative mechanical failure of TEA in 3-9 % of patients with acute fracture [61,68,69]. As mentioned above, TEA seems to have been showing promising results for complex fracture treatment in the elderly patient suffering from osteoporosis [70]. Conservative treatment is today a rarely considered option in treating distal humerus fractures.…”

Section: Tt Treatmentmentioning

confidence: 98%

Distal humerus fractures: a review of current therapy concepts

Steinitz

Sailer

Rikli

2016

Curr Rev Musculoskelet Med

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Fractures of the distal humerus in the adult comprise approximately one third of all humeral fractures. Successful management of distal humerus fractures depends on correct reduction of the fracture, reconstruction of the articular surface if needed, stability and rigidity of the fixation, and appropriate rehabilitation. In this review, we evaluated the available literature and highlighted current therapy concepts. We assessed the evolution of internal fixation and elbow arthroplasty focusing on the established surgical approaches against the background of a growing incidence of distal humeral fractures in an aging patient population. Therefore evaluating the aspect and influence of age-dependent comorbidities like osteoporosis on successful treatment.

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Section: Tt Treatmentmentioning

confidence: 98%

Distal humerus fractures: a review of current therapy concepts

Steinitz

Sailer

Rikli

2016

Curr Rev Musculoskelet Med

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“…In recent few years total elbow arthroplasty was appeared alternative method for intra-articular, comminuted distal humeral fractures for elderly 6,10) . But, complications of total elbow arthroplasty such as neurolysis, instability, infection, revisional surgery was remained obstacle to choose arthroplasty as primary method for fracture treatment 6,8,9) .…”

Section: Discussionmentioning

confidence: 99%

“…But, complications of total elbow arthroplasty such as neurolysis, instability, infection, revisional surgery was remained obstacle to choose arthroplasty as primary method for fracture treatment 6,8,9) . Especially in nonunion, controversy was existed.…”

Section: Discussionmentioning

confidence: 99%

Nonunion of Humeral Intercondylar Comminuted Fracture Treated with Fibular Graft - A Case Report -

Lee

Kwon

et al. 2010

J Korean Fract Soc

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Nonunion of comminuted distal humeral fracture is troublesome problem to orthopedic surgeon. We report a case of 59 years old woman, who suffered nonunion of comminuted distal humeral fracture previously treated by open reduction and internal fixation with plate and screws concomitantly autoiliac bone graft. We reconstructed humeral condyle with fibular inlay graft inside cortical shell of intercondylar bone fragment and obtained excellent result in radiological and functional outcome.Key Words: Humerus, Intercondylar fracture, Fibular graft, Non-union It has difficulty to treat distal humeral fracture in elderly over six decades because of extensive comminution and poor bone quality. Even though the bone defects due to severe comminution could be filled with iliac bone graft, the cancellous bone portion of iliac bone is easily resorbed. So, non-union was developed frequently in open reduction and internal fixation with iliac bone graft. In order to solve this problem, we could choose total elbow arthroplasty as alternative method for repairing non-union of distal humerus. But, complications of elbow arthroplasty itself are obstacle to choose this rising method. So, we reconstructed humeral condyle with fibular inlay graft making triangular structure inside cortical shell of intercondylar bone fragments. It obtained relatively good clinical result. So, we introduce this procedure for one of treatment option for repairing non-union of comminuted distal humeral fractures.

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“…80 % und nach 20 Jahren ca. 60 % der Prothesen ohne Anzeichen eines Implantatversagens oder einer Prothesenlockerung [2,4,6,11,12,[16][17][18].…”

Section: Ergebnisse Nach Gelenkersatzunclassified

Endoprothetische Versorgung nach distalen Humerusfrakturen

Becker¹,

Schmidt-Horlohé²,

Hoffmann³

2012

OP-JOURNAL

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Zusammenfassung Tr?mmerfrakturen des distalen Humerus, insbesondere bei Patienten mit einer Osteoporose, stellen eine gro?e Herausforderung an den behandelnden Unfallchirurgen dar. Ist eine Gelenkrekonstruktion und osteosynthetische Versorgung nicht m?glich, kann der prim?re endoprothetische Ersatz des Ellenbogens eine m?gliche Behandlungsalternative darstellen. Auch Patienten mit einer Vorsch?digung des Ellenbogens, z.?B. im Rahmen einer rheumatischen Erkrankung oder einer vorbestehenden posttraumatischen Arthrose, k?nnen von einer Prothese profitieren. Gerade bei geriatrischen Patienten ist die Narkosef?higkeit infolge von Begleiterkrankungen h?ufig eingeschr?nkt. Durch die im Schnitt deutlich k?rzeren OP-Zeiten und das Vermeiden der, f?r eine Osteosynthese meist notwendigen, Bauchlage kann auch in diesen F?llen eine operative Therapie m?glich sein und eine konservative Therapie und deren h?ufig schlechte Ergebnisse vermieden werden. Im Rahmen von klinischen Untersuchungen zeigt sich ein meist gutes bis sehr gutes funktionelles Outcome bei gleichzeitig guten Prothesenstandzeiten und einem moderaten Komplikationsrisiko, insbesondere im Vergleich zu einer herk?mmlichen Gelenkrekonstruktion.

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A multicenter, prospective, randomized, controlled trial of open reduction—internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients

Cited by 427 publications

References 25 publications

Distal humerus fractures: a review of current therapy concepts

Distal humerus fractures: a review of current therapy concepts

Nonunion of Humeral Intercondylar Comminuted Fracture Treated with Fibular Graft - A Case Report -

Endoprothetische Versorgung nach distalen Humerusfrakturen

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