Surgical and Nonoperative Management of Olecranon Fractures in the Elderly: A Systematic Review and Meta-Analysis.
Journal
Journal of orthopaedic trauma
ISSN: 1531-2291
Titre abrégé: J Orthop Trauma
Pays: United States
ID NLM: 8807705
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
accepted:
10
06
2020
pubmed:
23
6
2020
medline:
22
6
2021
entrez:
23
6
2020
Statut:
ppublish
Résumé
The aim of this comparative effectiveness study was to perform a meta-analysis of adverse events and outcomes in closed geriatric olecranon fractures, without elbow instability, after treatment with surgical or nonoperative management. PubMed, Web of Science, and Embase databases. Articles were included if they contained clinical data evaluating outcomes in patients ≥65 years of age with closed olecranon fractures, without elbow instability, treated surgically, or with nonoperative management. Data regarding patient age, olecranon fracture type, fracture union, adverse events, reoperation, elbow range of motion, and surgeon and patient reported outcome measures were recorded according to intervention. The interventions included for analysis were tension band wire fixation, plate fixation, or nonoperative management. Separate random effects meta-analyses were conducted for each outcome according to intervention. Prevalence and 95% confidence intervals were calculated for dichotomous variables, whereas weighted means and confidence intervals were calculated for continuous variables. Comparable outcomes were achieved with surgical or nonoperative management of olecranon fractures in geriatric patients. Surgical intervention carried a high risk of reoperation regardless of whether plate or tension band wire fixation was used. Functional nonunion can be anticipated if nonoperative treatment is elected in low-demand elderly patients. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Identifiants
pubmed: 32569071
pii: 00005131-202101000-00004
doi: 10.1097/BOT.0000000000001865
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
10-16Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
M. J. Gardner receives personal fees from Pacira Pharmaceuticals, Biocomposites, BoneSupport AB, Conventus, Globus Medical, StabilizOrtho, Synthes, and from KCI outside of the submitted work. J. A. Bishop receives personal fees from Globus Medical and Innomed outside of the submitted work. A. D. Duckworth receives personal fees from Elsevier, Taylor and Francis outside of the submitted work. A. D. Duckworth also receives educational and research support from Acumed and Smith and Nephew outside of the submitted work. The remaining authors report no conflict of interest.
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