AAOS2017: Long-term implant survival of TEA vs ORIF of distal humeral fractures

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
42 elderly patients with a comminuted, intraarticular fracture of the distal humerus were randomized to either total elbow arthroplasty or open reduction and internal fixation. Reported results included survivorship and incidence of revision. Intraoperatively, five cases Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Intraarticular fractures of the distal humerus can be particularly difficult to address. While standard treatment has traditionally been open reduction and internal fixation, the development of total elbow arthroplasty has provided an alternative method of managing these injuries. Few studies, however, have examined and compared long-term outcomes of these treatment options.
What was the principal research question?
In the treatment of comminuted intra-articular distal humeral fracture, is there any significant difference between total elbow arthroplasty (TEA) and open reduction and internal fixation (ORIF) after an average of 8-year follow-up?
Population: 42 patients, over the age of 65 years, with a comminuted intraarticular fracture of the distal humerus
Intervention: TEA group: Participants underwent total elbow arthroplasty (n=21 randomized)
Comparison: ORIF group: Participants underwent open reduction and internal fixation. (n=21 randomized))
Outcomes: Outcomes included patient-reported pain and function, the incidence of revision, and implant survivorship.
Methods: RCT
Time: Mean follow-up was 8.3 years (Range 1.9-14.2)
What were the important findings?
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What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.