Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 24;17(5):641-654.
doi: 10.1177/17585732241283909. eCollection 2025 Oct.

Outcomes at mean follow-up of four years following AO type-C distal humerus fractures managed with fixation or arthroplasty

James Allen  1 , Luke Budworth  2 , Paul Cowling  1 , Charlotte Tunstall  1 , David Limb  1 , Sam Vollans  1
Affiliations

Outcomes at mean follow-up of four years following AO type-C distal humerus fractures managed with fixation or arthroplasty

James Allen et al. Shoulder Elbow. .

Abstract

Aim: To compare outcomes between open reduction internal fixation (ORIF), total elbow replacement (TER) and distal humerus hemiarthroplasty (DHH) for AO type-C (AOC) fractures of the distal humerus in patients aged 50 years or older.

Methods: A retrospective analysis of acute AOC distal humerus fractures in patients aged 50 years or older between 2016 and 2022. Outcomes measured: Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complication rate, re-operation rate and range of movement (ROM).

Results: Sixty-five patients met the inclusion criteria (20 males, 45 females). Mean age was 64.4, 77.1 and 61.3 years old for ORIF, TER and DHH respectively. Logistic model analysis revealed a statistically significant increased complication rate in the ORIF group compared to the TER and DHH groups (ORIF vs TER p = 0.01; ORIF vs DHH p = 0.048). There was a higher re-operation rate in the ORIF group compared to the DHH group (p = 0.03). There were no differences in OES, MEPS or ROM between groups.

Discussion: This supports the use of TER in elderly patients with AOC distal humerus fractures. In the younger patient, DHH may have lower rates of complications and re-operations compared to ORIF, but function remains similar. We propose a prospective randomised control trial.

Keywords: DHH; ORIF; TER; distal humerus; distal humerus hemiarthroplasty; elbow; fixation; fracture; total elbow replacement; trauma.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Predicted probabilities for any re-operation.
Figure 2.
Figure 2.
Predicted probabilities for any complication.
Figure 3.
Figure 3.
Mean OES for each group.
Figure 4.
Figure 4.
Mean MEPS for each group.
Figure 5.
Figure 5.
Mean ROM for each group.
See this image and copyright information in PMC

References

    1. Webb L. Fractures of the distal humerus. In: Rockwood CA, Gree DP, Bucholz RW, et al. (eds) Rockwood and green's fractures in adults. Philadephia: Lippincott Williams & Wilkins, 2001.
    1. Meinberg EG, Agel J, Roberts CS, et al. Fracture and dislocation classification compendium—2018. J Orthop Trauma 2018; 32: S1–S170. - PubMed
    1. Frattini M, Soncini G, Corradi M, et al. Mid-term results of complex distal humeral fractures. Musculoskelet Surg 2011; 95: 205–213. - PubMed
    1. Seok HG, Park JJ, Park SG. Comparison of the complications, reoperations, and clinical outcomes between open reduction and internal fixation and total elbow arthroplasty for distal humeral fractures in the elderly: a systematic review and meta-analysis. J Orhop Sug Res 2022; 11: 5775. - PMC - PubMed
    1. Frechette GM, Chan JJ, Kim JM, et al. The outcomes of intra-articular distal humerus open reduction internal fixation using parallel precontoured plates in the elderly. J Hand Surg Am 2023; 48: 830.e1–830.e8. - PubMed

LinkOut - more resources