Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review
Background: Open reduction and internal fixation (ORIF) is the standard treatment for multifragmentary intra-articular distal humeral fractures. Fractures not amenable by ORIF are treated with total elbow arthroplasty (TEA). In recent years, elbow hemiarthroplasty (EHA) has been used as an alternati...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638322001359 |
| _version_ | 1811282850365833216 |
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| author | Andreas F. Nielsen, MD Ali Al-Hamdani, MD Jeppe V. Rasmussen, PhD Bo S. Olsen, PhD |
| author_facet | Andreas F. Nielsen, MD Ali Al-Hamdani, MD Jeppe V. Rasmussen, PhD Bo S. Olsen, PhD |
| author_sort | Andreas F. Nielsen, MD |
| collection | DOAJ |
| description | Background: Open reduction and internal fixation (ORIF) is the standard treatment for multifragmentary intra-articular distal humeral fractures. Fractures not amenable by ORIF are treated with total elbow arthroplasty (TEA). In recent years, elbow hemiarthroplasty (EHA) has been used as an alternative to TEA, as weight bearing restrictions and risk of component loosening are lower. We systematically reviewed the literature reporting functional outcomes and complication rates after either EHA or ORIF for Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures. Methods: We searched PubMed, Embase, The Cochrane Library, and Scopus. The inclusion criteria were at least 5 patients, aged ≥50 years, AO/OTA type 13C fracture treated with ORIF or EHA, and evaluation with the Mayo Elbow Performance Score. Literature screening and data extraction were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The results were synthesized qualitatively using weighted means. No comparative statistical analyses were done. Results: We included 27 articles, which included 96 patients treated with EHA and 535 patients treated with ORIF. We identified 1 randomized controlled trial and 26 case series. The weighted mean Mayo Elbow Performance Score was 86.9 (n = 89) in the EHA group and 84.7 (n = 535) in the ORIF group. There were 26 (33%) complications (n = 78) in the EHA group and 103 (38%) complications (n = 270) in the ORIF group. Complication rates were generally high in both groups. Conclusion: We found comparable results of EHA and ORIF, which indicate that EHA is a viable treatment option for AO/OTA type 13C fractures not amenable by ORIF. Because of high risk of bias, interpretation of the results should be done with caution. |
| first_indexed | 2024-04-13T01:59:58Z |
| format | Article |
| id | doaj.art-f5763e3d702c4c06869d4927c2fe7869 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-04-13T01:59:58Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-f5763e3d702c4c06869d4927c2fe78692022-12-22T03:07:39ZengElsevierJSES International2666-63832022-09-0165713722Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic reviewAndreas F. Nielsen, MD0Ali Al-Hamdani, MD1Jeppe V. Rasmussen, PhD2Bo S. Olsen, PhD3Department of Orthopaedic Surgery, Herlev and Gentofte Hospital, Hellerup, Denmark; Corresponding author: Andreas Falkenberg Nielsen, MD, Skulder-, Albue- og Håndkirurgi, klinik 1, Gentofte Hospital, Gentofte Hospitalsvej 17, st, 2900 Hellerup, Denmark.Department of Orthopaedic Surgery, Herlev and Gentofte Hospital, Hellerup, DenmarkDepartment of Orthopaedic Surgery, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Clinical Medicine, University of Copenhagen, København N, DenmarkDepartment of Orthopaedic Surgery, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Clinical Medicine, University of Copenhagen, København N, DenmarkBackground: Open reduction and internal fixation (ORIF) is the standard treatment for multifragmentary intra-articular distal humeral fractures. Fractures not amenable by ORIF are treated with total elbow arthroplasty (TEA). In recent years, elbow hemiarthroplasty (EHA) has been used as an alternative to TEA, as weight bearing restrictions and risk of component loosening are lower. We systematically reviewed the literature reporting functional outcomes and complication rates after either EHA or ORIF for Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures. Methods: We searched PubMed, Embase, The Cochrane Library, and Scopus. The inclusion criteria were at least 5 patients, aged ≥50 years, AO/OTA type 13C fracture treated with ORIF or EHA, and evaluation with the Mayo Elbow Performance Score. Literature screening and data extraction were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The results were synthesized qualitatively using weighted means. No comparative statistical analyses were done. Results: We included 27 articles, which included 96 patients treated with EHA and 535 patients treated with ORIF. We identified 1 randomized controlled trial and 26 case series. The weighted mean Mayo Elbow Performance Score was 86.9 (n = 89) in the EHA group and 84.7 (n = 535) in the ORIF group. There were 26 (33%) complications (n = 78) in the EHA group and 103 (38%) complications (n = 270) in the ORIF group. Complication rates were generally high in both groups. Conclusion: We found comparable results of EHA and ORIF, which indicate that EHA is a viable treatment option for AO/OTA type 13C fractures not amenable by ORIF. Because of high risk of bias, interpretation of the results should be done with caution.http://www.sciencedirect.com/science/article/pii/S2666638322001359Elbow fracturesDistal humeral fracturesFracture fixationOsteosynthesisArthroplastyAO type C |
| spellingShingle | Andreas F. Nielsen, MD Ali Al-Hamdani, MD Jeppe V. Rasmussen, PhD Bo S. Olsen, PhD Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review JSES International Elbow fractures Distal humeral fractures Fracture fixation Osteosynthesis Arthroplasty AO type C |
| title | Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review |
| title_full | Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review |
| title_fullStr | Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review |
| title_full_unstemmed | Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review |
| title_short | Elbow hemiarthroplasty vs. open reduction internal fixation for acute Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 13C fractures—A systematic review |
| title_sort | elbow hemiarthroplasty vs open reduction internal fixation for acute arbeitsgemeinschaft fur osteosynthesefragen orthopaedic trauma association ao ota type 13c fractures a systematic review |
| topic | Elbow fractures Distal humeral fractures Fracture fixation Osteosynthesis Arthroplasty AO type C |
| url | http://www.sciencedirect.com/science/article/pii/S2666638322001359 |
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