Meta-analysis Of Open Reduction And Internal Fixation Versus Total Elbow Arthroplasty For Distal Humeral Fracture In The Elderly

Objective:Meta-analysis was used to investigate the difference in postoperative complications and effectiveness between open reduction and internal fixation(ORIF)and total elbow arthroplasty(TEA)in the treatment of elderly patients with distal humeral fractures(DHF).Methods:The computer retrieves databases such as Pubmed,The Cochrane library,EMBASE,Science Direct,CNKI,Wanfang,and Weipu.To collect various controlled studies on QRIF/TEA treatment of DHF,select the operation time,postoperative complications,common complications(infection,heterotopic ossification),elbow flexion and extension,elbow function score(MEPS)),Upper Limb Function Survey Scale(DASH)score,and reoperation as an evaluation index for Meta analysis,using Rev Man 5.3 for analysis.Results:A total of 10 studies were included in 1069 patients.The results of the study showed that the incidence of total complications in the two groups(OR=1.67,95% CI: 1.19-2.35,P=0.003),MEPS score at the last follow-up(MD=-12.68,95% CI-16.60,-8.77,P<0.00001),flexion and extension of elbow joint(MD=-14.64,95CI-19.56,-9.71,P<0.00001),upper limb function survey scale(DASH)score(MD=12.99,95 CI 6.47,19.51,P<0.0001)It is statistically significant.The mean operation time,infection,heterotopic ossification,and complications/reoperation were not statistically significant(P>0.05).Conclusion:The incidence of postoperative complications in the TEA group was lower than that in the ORIF group,and elbow joint function superior to the ORIF group was obtained.For the elderly distal radius fracture,the patient is accompanied by varying degrees of osteoporosis,the joint surface is difficult to effectively reset,TEA should be considered.