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Complex elbow fracture-dislocations– what factors are associated with a poor post-operative outcome?

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Despite standardized treatment algorithms, patients with complex elbow fracture-dislocation frequently suffer from poor post-operative elbow function leading to reduced quality of life. Up to now, there is no valuable data regarding risk factors that lead to poor post-operative outcome after surgical reconstruction of complex elbow fracture-dislocations.

Methods

From 06/2010 to 12/2020 134 patients (51.3 ± 15.1 years, 44% women) undergoing surgical treatment of complex elbow fracture-dislocations could be included in this study. Follow-up period was 4.4 years (SD 2.5). All patients were clinically evaluated for elbow movement, elbow stability and common elbow scores (MEPS, OES, DASH-Score). Potential risk factors for poor post-operative outcome were identified using bi- and multivariate analyses.

Results

Overall good post-operative outcome has been achieved, mean MEPS was 88.8 ± 17.6. Post-operative complications occurred in 31.3% of the cases, while 25.4% required surgical revision. Patients with transolecranon dislocation fractures showed the significantly worst functional outcomes (p = 0.01). In addition, it has been shown that a patient’s age of more than 70 years (OR = 10, p = 0.003) and a BMI of more than 35 kg/m2 (OR = 7.6, p = 0.004) are independent risk factors for a poor post-operative outcome. In contrast, gender and time to surgery showed no significant influence on post-operative outcome.

Conclusion

In most cases, good post-operative functional results can be achieved using standardized treatment protocols. However, complication and revision rates remain high. Patients older than 70 years of age or with a BMI over 35 kg/m2 are at risk for an inferior outcome and require close follow-up monitoring.

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Funding

The authors declare that no benefit in any form have been received or will be received from a commercial party related directly or indirectly to the preparation and the subject of this manuscript.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedic Surgery, BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Germany

    Tim Jakobi, Yves Gramlich, Matthias Sauter, Matthias Schnetz, Reinhard Hoffmann & Alexander Klug

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  1. Tim Jakobi
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  2. Yves Gramlich
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  3. Matthias Sauter
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  4. Matthias Schnetz
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  5. Reinhard Hoffmann
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  6. Alexander Klug
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Contributions

Tim Jakobi: Conceptualized and designed the study, Examined the patients, Analysed and interpreted the data, Performed the statistical analysis, Wrote and revised the manuscript.

Yves Gramlich: Proofread the manuscript, Analysed the data.

Matthias Sauter: Proofread the manuscript, Analysed the data.

Matthias Schnetz: Proofread the manuscript, Analysed the data.

Reinhard Hoffmann: Proofread the manuscript, Conceived, and designed the study, Provided administrative, technical, and material support.

Alexander Klug: Proofread the manuscript, Reviewed the literature, Analysed the data, Provided administrative, technical, and material support.

Corresponding author

Correspondence to Tim Jakobi.

Ethics declarations

Ethics approval

The study has been approved by the Ethical Committee of the Regional Medical board of Hessen, Germany (FF3/2019). All investigations were conducted in conformity with the principles of good clinical practice and the ethical principles of research.

Informed consent

was obtained from all individual participants included in the study.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

There is no individual participant data in our manuscript.

Competing interests

The authors have no relevant financial or non-financial interests to disclose.

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Cite this article

Jakobi, T., Gramlich, Y., Sauter, M. et al. Complex elbow fracture-dislocations– what factors are associated with a poor post-operative outcome?. Eur J Trauma Emerg Surg (2024). https://doi.org/10.1007/s00068-024-02531-w

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  • DOI: https://doi.org/10.1007/s00068-024-02531-w

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