[Fractures of the distal humerus in the elderly : osteosynthesis or elbow arthoplasty ?]

With an aging population, distal humerus fractures are becoming an emerging problem. Whereas open reduction and internal fixation has been the treatment of choice, results have not been as conclusive in elderly patients. Over two thirds of the cases in this population present with a highly comminuted articular fracture and poor bone stock, jeopardizing the quality and stability of the construct. Total elbow arthroplasty has gained popularity in the treatment of such fractures, and has shown higher results in terms of pain, function, and patient satisfaction. Nevertheless, it also has a high complication rate, such as infection, ulnar neuropathy and loosening, that should be discussed with patients before surgery. The aim of this article was thus to review the different treatment options and propose a treatment algorithm.