Complications of Early Versus Delayed Total Elbow Arthroplasty(TEA) in the Treatment of Distal Humerus Fractures.
David Macknet, MD1; Patrick Marinello, MD2; Bryan Loeffler, MD2; Glenn Gaston, MD2
1Atrium Health, Charlotte, NC, 2OrthoCarolina Hand Center, Charlotte, NC
Acute treatment of distal humerus fractures with TEA resulted in a higher incidence of reoperation compared to delayed treatment while having similar rates of wound complications and heterotopic ossification(HO).
Materials & Methods:
We retrospectively reviewed 76 patients who had TEA performed at our institution within 1 year of a distal humerus fracture. This group was divided into 2 cohorts: the acute group, 51 patients, had TEA performed within 2 weeks of injury; the chronic group, 25 patients, had treatment between 2 weeks and 1 year. We calculated the wound complication, heterotopic ossification, and reoperation rates at final follow up.
The demographics were similar between groups with an average age of 72 at time of injury. The overall rate of HO at 47.3% (36/76) was not significantly different between groups (p=0.172). Likewise, the rate of wound complications 17.1% (13/76) did not vary between cohorts (p=0.748). There was a higher rate of clinically significant HO (requiring excision or loss functional range of motion) occurring in 25.5% (13/51) of the acute group versus 8.0% (2/25) in the delayed(p=0.12). The overall reoperation rate was 18.4% (14/76) occurring in 25.5% (13/51) of the acute group and 4.0% (1/25) in the delayed group (p=0.027).
TEA for distal humerus fractures results in a high rate of HO and wound complications. Acute treatment of these fractures with TEA results in a higher rate of reoperation and clinically significant HO when compared to delayed treatment.
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