Distal humerus fractures in the elderly: osteosynthesis or endoprosthesis? Review of the literature

Abstract

Fractures of the distal humerus in adults are rare but challenging for the orthopaedic trauma surgeon. The bimodal distribution reflects the trauma mechanism. While distal humerus fractures are caused by high-energy traumata in young male adults, a fall from a standing height is the most common reason for humerus fractures among elderly females. As a rule, fractures of the distal humerus are treated surgically. In young patients, open reduction and internal fixation (ORIF) with anatomic locking plates are the gold standard. In elderly patients, reconstruction is not always possible, and total elbow arthroplasty (TEA) becomes necessary. The present article provides an overview of the current diagnostic and treatment recommendations. The current literature is reviewed and the results discussed.

Keywords: Distal humerus fractures; Elderly patients; Fractures of the elbow; Guidelines; Open reduction internal fixation; Outcome; Review; Total elbow arthroplasty; Young patients.