Total Elbow Arthroplasty Versus Open Reduction and Internal Fixation for Distal Humerus Fractures: A Propensity Score Matched Analysis of 30-Day Postoperative Complications.

Autor:	Sandoval LA; Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA., Reiter CR; Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA., Wyatt PB; Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA., Satalich JR; Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA., Ernst BS; Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA., O'Neill CN; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA., Vanderbeck JL; Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA.
Jazyk:	angličtina
Zdroj:	Geriatric orthopaedic surgery & rehabilitation [Geriatr Orthop Surg Rehabil] 2024 Jun 06; Vol. 15, pp. 21514593241260097. Date of Electronic Publication: 2024 Jun 06 (Print Publication: 2024).
DOI:	10.1177/21514593241260097
Abstrakt:	Introduction: Open reduction and internal fixation (ORIF) is an established surgical procedure for distal humeral fractures; however, total elbow arthroplasty (TEA) has become an increasingly popular alternative for elderly patients with these injuries. Using a large sample of recent patient data, this study compares the rates of short-term complications between ORIF and TEA and evaluates complication risk factors. Methods: Patients who underwent primary TEA or ORIF from 2012 to 2021 were identified by Current Procedural Terminology codes in the American College of Surgeons National Surgical Quality Improvement Program database. Propensity score matching controlled for demographic and comorbid differences. The rates of 30-day postoperative complications were compared. Results: A total of 1539 patients were identified, with 1365 (88.7%) and 174 (11.3%) undergoing ORIF and TEA, respectively. Patients undergoing TEA were older on average (ORIF: 56.2 ± 19.8 years, TEA: 74.3 ± 11.0 years, P < .001). 348 patients were included in the matched analysis, with 174 patients in each group. TEA was associated with an increased risk for postoperative transfusion (OR = 6.808, 95% CI = 1.355 - 34.199, P = .020). There were no significant differences in any adverse event (AAE) between procedures ( P = .259). A multivariate analysis indicated age was the only independent risk factor for the development of AAE across both groups (OR = 1.068, 95% CI = 1.011 - 1.128, P = .018). Conclusion: The risk of short-term complications within 30-days of ORIF or TEA procedures are similar when patient characteristics are controlled. TEA, however, was found to increase the risk of postoperative transfusions. Risks associated with increasing patient age should be considered prior to either procedure. These findings suggest that long-term functional outcomes can be prioritized in the management of distal humerus fractures. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2024.)
Databáze:	MEDLINE
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