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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Open reduction and internal fixation versus total elbow arthroplasty for the treatment of geriatric distal humerus fractures: a systematic review and meta-analysis

Review published: 2013.

Bibliographic details: Githens M, Yao J, Sox AH, Bishop J.  Open reduction and internal fixation versus total elbow arthroplasty for the treatment of geriatric distal humerus fractures: a systematic review and meta-analysis. Journal of Orthopaedic Trauma 2013: epub. [PubMed: 24375273]

Abstract

OBJECTIVES:: The purpose of this systematic review and meta-analysis was to pool and analyze outcomes and complication rates in elderly patients with intra-articular distal humerus fractures being treated with either total elbow arthroplasty (TEA) or open reduction and internal fixation (ORIF) with locking plates.

DATA SOURCES:: PubMed, Embase and the Cochrane databases were utilized. The search included publications up to June 2013. Article selection was independently performed by two authors and disagreements were resolved by consensus.

STUDY SELECTION:: Studies meeting criteria for inclusion were observational cohort studies or randomized controlled trials evaluating functional and radiographic outcomes and complications in elderly patients treated for distal humerus fractures with either primary TEA or ORIF with locking plates. Studies with mean age < 60 years, indications for TEA other than acute fracture, and those including non-locked plates were excluded.

DATA EXTRACTION:: Standardized data extraction was performed. A quality assessment tool was used to evaluate individual study methodology.

DATA SYNTHESIS:: Descriptive statistics for functional outcomes were reported. Meta-analysis and regression analysis were performed for complication rates.

CONCLUSIONS:: A systematic review and meta-analysis revealed that TEA and ORIF for the treatment of geriatric distal humerus fractures produced similar functional outcome scores and range of motion. While there was a trend towards a higher rate of major complications and reoperation after ORIF this was not statistically significant. The quality of study methodology was generally weak. Ongoing research including prospective trials and cost-analysis is indicated to better define the roles of ORIF versus TEA in the management of these injuries.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2013 University of York.

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