Epidemiology of distal humerus fractures in the elderly.

INTRODUCTION

Despite recent treatment advances, management of distal humerus fractures in the elderly remains one of the most challenging aspects of trauma surgery. Although these fractures are relatively rare, they fall under the umbrella of osteoporotic fractures, which themselves are increasing in frequency.

MATERIAL AND METHODS

Two studies were performed: one retrospective study of 410 patients over a 10-year period and one prospective study of 87 patients over a 1.5-year period. This allowed us to analyse the epidemiology of distal humerus fractures in subjects above 64years of age in 19 different French hospitals. All of the included patients were reviewed, except for one subject in the retrospective study who had died, but whose data was still used.

RESULTS

Most of the fractures were AO type C, occurred in women in more than 80%, and occurred in nearly one of two persons above 80 years of age. Most of the patients had a high level of autonomy and lived at home. Unlike other upper limb fracture sites, nearly 90% of patients required surgical treatment. The presence of osteoporosis was found to have a tremendous impact on fracture care, complications and results.

CONCLUSION

Functional status is more important than chronological age in this patient population; the former must be taken into account when determining treatment indications.

LEVEL OF EVIDENCE

Level IV.