Hemiarthroplasty vs. open reduction and internal fixation for comminuted distal humerus fractures in patients under 65 years: a systematic review
Bibliographic record
Abstract
Background: Comminuted articular fractures of the distal humerus present a significant surgical challenge due to their complexity. Complications are common, and achieving optimal functional outcomes is crucial, particularly in young, active patients. This study aims to compare the outcomes of open reduction and internal fixation (ORIF) with those of hemiarthroplasty (HA) in patients under 65 years old. Methods: This study is a systematic review and comparative analysis of patients under 65 years of age with comminuted articular fractures of the distal humerus, identified from the existing literature. A comprehensive search of PubMed, Cochrane, and Embase databases was conducted using predefined keywords. Only studies providing detailed individual patient data, including preoperative diagnosis and clinical outcomes after either ORIF or HA, were included. Patients were allocated into 2 groups (ORIF and HA) based on the reported surgical procedure. The primary outcomes assessed were functional results (range of motion, pain (visual analog scale); Disabilities of the Arm, Shoulder, and Hand; and Mayo Elbow Performance scores) and complication rates. The risk of bias and methodological quality of included studies were assessed using the Newcastle-Ottawa Scale. Results: = .027). Conclusion: For comminuted distal humerus fractures in young patients, ORIF appears to be the preferred surgical option, offering superior functional outcomes and a lower incidence of complications and heterotopic ossification. HA can be used in highly comminuted fractures that cannot be reconstructed with a solid ligament suture or column osteosynthesis and without olecranon osteotomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.007 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".