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Outcomes of distal humerus fractures: What are we measuring? - 23/11/18

Doi : 10.1016/j.otsr.2018.08.017 
Ali Zarezadeh a, Kelly Mamelson b, W. Christian Thomas a, Bradley S. Schoch a, Thomas W. Wright a, Joseph J. King a,
a Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA 
b College of Medicine, Florida State University, Tallahassee, FL, USA 

Corresponding author. Orthopaedics and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, 32611 Florida, USA.Orthopaedics and Sports Medicine Institute, University of Florida3450 Hull Road, GainesvilleFlorida32611USA

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Abstract

Introduction

We evaluate the most common outcome measures used in distal humerus fracture studies in order to suggest standardization for future research.

Materials and methods

A systematic review identified articles assessing the outcomes of acute distal humerus fractures from 2006 to 2016 from PubMed and Web of Science databases. The inclusion criterion was studies reporting on the outcomes of treatment of acute distal humerus fractures. Review articles, meta-analyses, studies with<5 patients, technique articles, biomechanical studies, and those focusing on one complication/outcome were excluded. Patient demographics and all outcome measures were reviewed. Journal and demographic factors were then compared.

Results

One-hundred-nine of 2158 articles met inclusion criteria. The median number of fractures per study was 35. Mean patient age was 55.0 years. Average follow-up was 35 months. Range-of-motion and strength measurements were reported in 90% and 17% of studies, respectively. Twenty patient-reported outcome instruments were used. The most commonly reported measures were MEPS, DASH, VAS pain, and Quick DASH scores. An average of 1.9 outcome measures were reported per study. A journal impact factor of1.5 was associated with more reported outcome measures. Articles including elbow arthroplasty were associated with higher impact factor journals, more outcome measures, and longer follow-up. Level of evidence was not associated with the number of reported outcome measures.

Discussion

The current distal humerus fracture literature inconsistently reports outcome measures. More outcome measures were reported in higher impact journals. Future distal humerus fracture studies should include MEPS, DASH or Quick DASH, and VAS Pain scores to allow for appropriate cross-study comparison.

Level of evidence

IV, Systematic review.

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Keywords : Distal humerus fracture, Journal impact factor, Outcome measures, Patient-reported outcome instruments


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Vol 104 - N° 8

P. 1253-1258 - décembre 2018 Regresar al número
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