Clinical Research
Risk factors for elbow stiffness after open reduction and internal fixation for intercondylar fractures of the distal humerus
Hua Kehan, Chen Chen, Li Ting, Jiang Xieyuan, Zha Yejun, Gong Maoqi, Sun Weitong, Lu Shuai
Published 2019-11-15
Cite as Chin J Orthop Trauma, 2019,21(11): 966-972. DOI: 10.3760/cma.j.issn.1671-7600.2019.11.007
Abstract
ObjectiveTo explore the risk factors for elbow stiffness after open reduction and internal fixation (ORIF) for intercondylar fractures of the distal humerus.
MethodsFrom January 2013 to May 2017, 159 patients underwent ORIF for intercondylar fractures of the distal humerus with dual plating. They were 83 males and 76 females with a mean age of 42.6 years (from 14 to 79 years). They were divided into 2 groups according to their range of motion at the latest follow-up and the secondary elbow arthrolysis they had undergone or not. The stiffness group had extension-flexion and/or pronation-supination <100° and secondary elbow arthrolysis while the non-stiffness group had extension-flexion and pronation-supination ≥100° and no secondary elbow arthrolysis. Age, gender, fracture side, mechanism of injury, AO fracture classification, open/close fracture, additional fracture, preoperative nerve injury, time from injury to surgery, surgical approach, configuration of plating, medication for anti-heterotopic ossification and implant removal were analyzed as risk factors for elbow stiffness using Logistic regression analysis.
ResultsThe mean follow-up period for this cohort was 32.0 months (from 10 to 63 months). The latest follow-up showed fracture union in all the patients. The stiffness group had 38 patients and the non-stiffness group 121. Multivariate regression analysis showed that high energy trauma (OR=3.141, 95%CI 1.396~7.070, P=0.006) and time from injury to surgery >one week (OR=2.596, 95%CI 1.123~6.000, P=0.026) were independent risk factors for elbow stiffness after ORIF for intercondylar fractures of the distal humerus.
ConclusionThe patients with high energy trauma and time from injury to surgery >one week should be treated with caution and special care in clinical practice because the 2 factors are closely related to posttraumatic elbow stiffness after ORIF for intercondylar fracture of the distal humerus.
Key words:
Elbow joint; Fracture fixation, internal; Risk factors; Intercondylar fractures
Contributor Information
Hua Kehan
Department of Orthopedic Trauma, Jishuitan Hospital, Beijing 100035, China
Chen Chen
Li Ting
Jiang Xieyuan
Zha Yejun
Gong Maoqi
Sun Weitong
Lu Shuai