Open Reduction and Internal Fixation Versus Total Elbow Arthroplasty for Intra-articular Distal Humerus Fractures in Patients 65 Years or Older: A Meta-analysis.

Study Summary

7 studies including patients with intra-articular distal humerus fractures (DHF) were included in this systematic review and meta-analysis comparing open reduction and internal fixation (ORIF) with total elbow arthroplasty (TEA). Pooled outcomes included elbow flexion-extension range of motion, Mayo Elbow Performance Score, surgical time, hospital length of stay, infection, other complications, and revision surgery. TEA provided a statistically greater flexion-extension arc, while all other pooled clinical, perioperative, and safety outcomes were comparable between treatments. However, the range-of-motion advantage was below commonly reported minimal clinically important difference thresholds, supporting individualized treatment rather than routine preference for arthroplasty.