Shu-Kun He1, Long Xu2, Jin-Hai Guo3, Jing-Ping Liao4, Ting-Wu Qin5, Fu-Guo Huang6. 1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Laboratory of Stem Cell and Tissue Engineering, West China Hospital, Sichuan University, Chengdu 610041, PR China. 2. Department of Orthopedics, Yaan People's Hospital, Yaan, Sichuan 625000, PR China. 3. Department of Orthopedics, The First People's Hospital of Jintang County, The Jintang Hospital of West China Hospital, Sichuan University, Chengdu, Sichuan 610031, PR China. 4. Department of Nursing, West China Hospital, West China School of Medicine, Sichuan University, Chengdu 610041, PR China. 5. Laboratory of Stem Cell and Tissue Engineering, West China Hospital, Sichuan University, Chengdu 610041, PR China. 6. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China. Electronic address: huang-f-g@163.com.
Abstract
BACKGROUND: Capitellum and trochlea fractures are truly rare and the treatment is not fully appreciated. So we evaluate the impact of associated injuries and fracture classifications on elbow functional outcomes after open reduction and internal fixation. MATERIALS AND METHODS: PubMed, Embase, Ovid Medline, and the Cochrane Library were searched from January 1, 1974 to January 1, 2017. All English literature with the treatment of capitellum and trochlea fractures by open reduction and internal fixation were included. RESULTS: For associated injuries, the results suggested that the MEPI score of patients without associated injuries was higher than that of patients with associated injuries (P = 0.001). However, there was no significant difference in the arc of motion between the two groups (P = 0.052). For Bryan and Morrey classification, there was no significant difference in the MEPI score (P = 0.622) and in the arc of motion (P = 0.652) between type-I fractures and type-IV fractures. For Dubberley classification, there was significant difference only in the MEPI score between subtype-A fractures and subtype-B fractures (P = 0.005). CONCLUSION: The associated injury of fracture may have a negative impact on the functional outcomes of elbow. And Dubberley classification is more suitable to classify this kind of fracture. Furthermore, high-quality studies are required to attain robust evidence.
BACKGROUND: Capitellum and trochlea fractures are truly rare and the treatment is not fully appreciated. So we evaluate the impact of associated injuries and fracture classifications on elbow functional outcomes after open reduction and internal fixation. MATERIALS AND METHODS: PubMed, Embase, Ovid Medline, and the Cochrane Library were searched from January 1, 1974 to January 1, 2017. All English literature with the treatment of capitellum and trochlea fractures by open reduction and internal fixation were included. RESULTS: For associated injuries, the results suggested that the MEPI score of patients without associated injuries was higher than that of patients with associated injuries (P = 0.001). However, there was no significant difference in the arc of motion between the two groups (P = 0.052). For Bryan and Morrey classification, there was no significant difference in the MEPI score (P = 0.622) and in the arc of motion (P = 0.652) between type-I fractures and type-IV fractures. For Dubberley classification, there was significant difference only in the MEPI score between subtype-A fractures and subtype-B fractures (P = 0.005). CONCLUSION: The associated injury of fracture may have a negative impact on the functional outcomes of elbow. And Dubberley classification is more suitable to classify this kind of fracture. Furthermore, high-quality studies are required to attain robust evidence.