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Clinical outcome and osteoarthritic changes after surgical treatment of isolated capitulum humeri fractures with a minimum follow-up of five years

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Abstract

Purpose

The aim of this study was to evaluate the functional outcome of patients treated for a fracture of the capitulum humeri and to analyze the grade of osteoarthritic changes.

Methods

Patients undergoing surgical reconstruction of isolated capitulum humeri fractures were included in a retrospective comparative analysis. Fractures were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) and Dubberley and were functionally evaluated by the American Shoulder and Elbow Surgeons Score (ASES) and the Mayo Elbow Performance Index (MEPI). Levels of arthritic changes were measured with the Broberg and Morrey Score. Frequency of complications was evaluated whereby all results were compared to the ipsilateral, unaffected side.

Results

Thirteen patients, ten females (76.9 %) and three males (23.1 %), with a mean age of 48.7 ± 13.3 years were included in the study. Long-term follow-up range of motion (ROM) in the sagittal plane was significantly influenced by time of surgery (p < 0.001), and long-term follow-up with respect to pronation and supination by ROM of the healthy control (p < 0.05). The average ASES score was 37.8, and the Mayo Elbow Performance Index (MEPI) was 92.7. The mean level of degenerative arthritic changes was 1.9 ± 0.6 on the fractured side and significantly less (0.8 ± 0.8) on the healthy side (pF-test < 0.001). At a mean follow-up of 118.5 ± 52.4 months neither nonunion nor avascular necrosis were observed in any case. However, six cases of heterotopic ossification were identified.

Conclusions

Satisfying functional outcomes and a low rate of osteoarthritic changes can be expected after the presented open reduction and internal fixation of capitulum humeri fractures.

Level of evidence

Level IV - Case series; therapeutic study.

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Authors and Affiliations

  1. Department of Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Harald K. Widhalm, Florian T. Wagner, Kambiz Sarahrudi, Harald Wolf & Stefan Hajdu

  2. Department of Maxillo-facial Surgery, Medical University of Vienna, Vienna, Austria

    Rudolf Seemann

  3. Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria

    Patrick Sadoghi

Authors
  1. Harald K. Widhalm
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  2. Rudolf Seemann
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  3. Florian T. Wagner
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  4. Kambiz Sarahrudi
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  5. Harald Wolf
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  6. Stefan Hajdu
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  7. Patrick Sadoghi
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Correspondence to Harald K. Widhalm.

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Widhalm, H.K., Seemann, R., Wagner, F.T. et al. Clinical outcome and osteoarthritic changes after surgical treatment of isolated capitulum humeri fractures with a minimum follow-up of five years. International Orthopaedics (SICOT) 40, 2603–2610 (2016). https://doi.org/10.1007/s00264-016-3165-8

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  • DOI: https://doi.org/10.1007/s00264-016-3165-8

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