Abstract
In the present retrospective study, we explored factors affecting the functional outcome of open reduction and internal fixation (ORIF) on intercondylar distal humeral fractures in patients over age 60. The medical records, radiographs, and radial T-scores of 68 consecutive elderly patients (aged between 60 and 86 years) with intercondylar (AO type C) distal humeral fractures treated with ORIF during March 2001–June 2009 were retrospectively reviewed. The Mayo Elbow Performance Score (MEPS) was used to assess the functional outcome after ORIF. Our results showed that the rate of excellent/good MEPS in patients who received ORIF through olecranon osteotomy (65.0%) was significantly higher than that in patients who received ORIF through the triceps-sparing approach (35.0%) (P < 0.05). Among patients with an excellent/good MEPS, the mean radial T-score in the olecranon osteotomy group was significantly lower than that in the triceps-sparing group (P < 0.05). Both univariate and multivariate logistic regression analyses revealed that patients with ≤12 days of immobilization tend to get an excellent/good MEPS. In conclusion, in patients over age 60, bone mineral density (BMD) represented by the radial T-score is a primary factor influencing the functional outcome of ORIF on intercondylar distal humeral fractures. Compared to the triceps-sparing approach, olecranon osteotomy can result in excellent/good functional outcome within a broader range of BMD, which may account for the significantly higher rate of excellent/good MEPS rating in elderly patients treated with olecranon osteotomy. In addition, early mobilization is recommended for elderly patients treated with ORIF for intercondylar distal humeral fractures.
Published Version
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