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Anales de la Facultad de Medicina

On-line version ISSN 2301-1254

Abstract

SPECKER GROSSO, Julián  and  TAMON, Nicolás. Distal humerus fractures in patients over 65 years: What is the best therapeutic option?. Anfamed [online]. 2020, vol.7, n.2, e303.  Epub Dec 01, 2020. ISSN 2301-1254.  https://doi.org/10.25184/anfamed2020v7n2a4.

Introduction:

Distal humerus fractures account for 2% of all fractures. It is the elderly patients who present the greatest therapeutic challenge. Osteoporotic bones, more common in this population, lead to the production of fractures with greater joint and metaphyseal comminution. As a result, stable and rigid fixation becomes more difficult, hindering early mobility. These characteristics generate controversy when choosing the appropriate treatment. The aim of this study is to review the literature of the last decade regarding the best therapeutic option for distal humerus fractures in elderly patients.

Methods:

A systematized search was performed through the electronic search engines PubMed and Timbó in august 2019. The search reached a total of 475 articles, of which 24 were selected according to inclusion and exclusion criteria.

Discussion:

Most of the studies analyzed are retrospective case series studies. In the articles reviewed, there are both extra and intra-articular fractures. The results of the different treatments performed were analyzed according to clinical parameters, functional scores and complications.

Conclusions:

Conservative treatment is a valid option for those patients where the terrain does not allow surgical intervention. For extra-articular and partial-articular fractures, open reduction and internal fixation is the treatment of choice. For complete articular fractures, there are no significant differences in scores used between open reduction and internal fixation and elbow replacement. There is a lack of prospective studies comparing both treatments.

Keywords : Fracture; Distal humerus; Treatment..

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