Summary
Evidence from one small randomized controlled trial and one small retrospective cohort
study suggests that treatment with total elbow arthroplasty (TEA) for distal humeral
fractures may lead to improved outcomes compared with open reduction and internal
fixation (ORIF). Patients receiving TEA had significantly better Mayo elbow performance
scores compared with those treated with ORIF. While those who had TEA tended to have
better patient-reported outcomes (DASH), greater range of motion, and lower reoperation
rates, the results did not consistently reach statistical significance. The treatment
groups were similar regarding postoperative complications; however, there were somewhat
conflicting results regarding heterotopic ossification. Both studies were limited
by small sample sizes and one study was limited by a relatively short follow-up time.
Both studies had a high percentage of female participants, which may limit the generalizability
of study results. Additional randomized studies with larger populations, longer follow-up,
and more balanced gender proportions are needed to confirm these results.
