Comparison of treatments in patients with distal humerus intercondylar fracture: a systematic review and meta-analysis.

INTRODUCTION

Distal humerus intercondylar fractures are intra-articular comminuted fractures of the elbow that involve soft tissue injury. We evaluate different surgical approaches and elbow functional outcomes in the treatment of distal humerus fracture.

MATERIALS AND METHODS

Medline, Cochrane, EMBASE, Google Scholar databases were searched up to 29 July 2016. All studies had to have evaluated the treatment of patients with intercondylar fractures of the distal humerus. The primary outcome was the incidence of functional grading of excellent/good.

RESULTS

The methods used to evaluate elbow function were diverse across the studies and included non-surgical, fixation and plating approaches. The most common surgical technique used was olecranon osteotomy (n = 7) and triceps-sparing (n = 5). In general, most procedures were associated with >70% of patients having excellent/good joint function following surgery. The meta-analysis included four studies with 276 patients, and compared olecranon osteotomy with triceps-sparing. The pooled analysis indicated that patients treated using olecranon osteotomy had better functional outcome than patients treated with triceps-sparing (pooled OR = 2.38, 95%CI: 1.25-4.55, p = .009).

CONCLUSIONS

This study found that a wide range of surgical procedures were effective in treating most patients with distal humerus intercondylar fractures, and that the approach of olecranon osteotomy may be more effective than that of triceps-sparing in restoring joint function. Key messages Most procedures in treating distal humerus intercondylar fractures were associated with >70% of patients having excellent/good joint function following surgery. The most common surgical technique used in treating distal humerus intercondylar fractures were olecranon osteotomy and triceps-sparing. The pooled analysis indicated that patients treated using olecranon osteotomy had better functional outcome than patients treated with triceps-sparing.