Risk factors for elbow stiffness after open reduction and internal fixation for intercondylar fractures of the distal humerus
10.3760/cma.j.issn.1671-7600.2019.11.007
- VernacularTitle: 肱骨髁间骨折切开复位内固定术后肘关节僵硬的危险因素分析
- Author:
Kehan HUA
1
;
Chen CHEN
;
Ting LI
;
Xieyuan JIANG
;
Yejun ZHA
;
Maoqi GONG
;
Weitong SUN
;
Shuai LU
Author Information
1. Department of Orthopedic Trauma, Jishuitan Hospital, Beijing 100035, China
- Publication Type:Clinical Trail
- Keywords:
Elbow joint;
Fracture fixation, internal;
Risk factors;
Intercondylar fractures
- From:
Chinese Journal of Orthopaedic Trauma
2019;21(11):966-972
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors for elbow stiffness after open reduction and internal fixation (ORIF) for intercondylar fractures of the distal humerus.
Methods:From 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.
Results:The 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.
Conclusion:The 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.
