The Results of Open Reduction and Internal Fixation in Elderly Patients with Severe Fractures of the Distal Humerus: A Critical Analysis of the Results

摘要

Displaced comminuted articular fractures of the distal humerus in the adults are difficult problems due to complex anatomy of the elbow, small fracture fragments and the limited amount of subchondral bone. The problem is much more difficult in the elderly. There is consensus that gradually the most favorable results of a displaced comminuted articular fractures of distal humerus are achieved by open reduction and internal fixation.1""6 However, some controversies remained in management of such fractures in the elderly. Recently, some investigators have recommended primary total elbow arthroplasty (TEA) for the management of such fractures in the elder and they report good short-term results.7"9 It is suggested that, for patients older than 60 to 65 years TEA is indicated. Gambirasio et al.10 further claimed that they had TEA as their treatment of choice in the elderly with a multifragmentary fracture of the distal humerus.