Distal Humerus Fracture in the Elderly - Fx or Replace?

Description

This is a transcription of a presentation given by Roger Van Riet at the Edinburgh Trauma Course regarding distal humerus fractures in elderly patients, focusing on treatment decisions, particularly between surgical options such as osteosynthesis and total elbow replacement. Roger expresses regret for not being able to attend in person due to a family vacation planned for Edinburgh's Fringe Festival. He discusses the definition of "elderly" for the context of his presentation, highlighting the multifactorial nature of health in this age group, particularly assessing general health, activity levels, and pre-existing conditions.



He outlines the common causes of distal humerus fractures, typically low-energy trauma in elderly patients, and emphasizes the importance of imaging for treatment planning. Roger contrasts surgical options (including various types of arthroplasty) with non-surgical approaches, illustrating cases where conservative treatment may be effective for non-displaced fractures. Throughout the presentation, he shares case studies demonstrating the outcomes of both surgical and non-surgical treatments, detailing the decision-making process based on patient health and fracture severity.



Finally, Roger concludes by asserting that while osteosynthesis is often preferred, total elbow replacement can also offer benefits for specific cases, stressing the importance of discussing limitations and making shared decisions with patients.

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