Distal humeral fractures

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.