Distal humerus hemiarthroplasty for complex intra-articular fractures in elderly or nonfixable patients: a meta-analysis of clinical and functional outcomes
Abstract
Background Distal humerus fractures are difficult to treat when fixation is not possible, particularly in elderly patients. While total elbow arthroplasty is often used in elderly patients, it is generally not suitable for younger or more active individuals. Distal humerus hemiarthroplasty (DHH) may represent a viable alternative in selected cases. This systematic review and meta-analysis aimed to evaluate the clinical and functional outcomes of DHH in patients with complex distal humerus fractures. Methods A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane Library were searched up to January 2024. Studies reporting outcomes of DHH for distal humerus fractures were included. Functional scores, range of motion, complications, and revision rates were pooled using a random-effects meta-analysis. Subgroup analyses were performed according to fracture type (Arbeitsgemeinschaft für Osteosynthesefragen classification) and surgical approach (triceps-on vs. triceps-off). Results Nineteen studies including 593 patients (mean age 68 years; mean follow-up 53 months) were analyzed. The pooled Mayo Elbow Performance Score was 84.7 [95% confidence interval: 80.8-88.5], and the Disabilities of the Arm, Shoulder and Hand score was 20.8 [13.6-28.0]. The mean flexion–extension arc was 102° [97-106], and the pronation–supination arc was 155° [147-162]. The overall complication…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 593 participants or records.
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