Timing of Surgery for Elbow Fractures (OTA 13 A-C and 21 A-C) and Patient Outcomes.

OBJECTIVES

To determine if there is a correlation between time to surgery (TTS) and outcomes after repair of elbow fractures.

DESIGN

Retrospective comparative study.

SETTING

A single, urban hospital system.

PATIENT SELECTION CRITERIA: Patients from March 2011 to September 2022 who sustained an isolated fracture about the elbow joint (AO/OTA 13-A, B, and C and 21-A, B, and C), underwent surgical repair, and had at least 6 months of postoperative follow-up identified from an Institutional Review Board-approved database.

OUTCOME MEASURES AND COMPARISONS: TTS, in days, was recorded. Radiographic and clinical follow-up was obtained at all visits, and a Mayo Elbow Performance Index was calculated based on the latest follow-up. Complications recorded include elbow contracture, infection, early hardware failure, reoperation, and fracture nonunion. Multivariable regression and Spearman correlation analysis were used to determine any significant outcome differences based on TTS.

RESULTS

Three hundred fifty-one patients included with a mean age of 54.8 (range: 18-86) years with 217 females (61.8%) and 134 males (38.2%). Eighty-two patients (23.4%) developed at least 1 complication, whereas 269 patients (76.6%) did not. As a continuous variable, TTS was not correlated with arc of motion at any follow-up visit nor with the latest recorded Mayo Elbow Performance Index score ( P > 0.05). Mean TTS for patients who did and did not experience a complication was 6 (range: 0-24) and 10 (range: 0-38) days, respectively, and this was not significantly different ( P = 0.217). Complication rate and any of the individual complications were not associated with TTS after a multivariable analysis controlling for age, sex, injury mechanism, open fracture, Charlson Comorbidity Index, and AO/OTA classification ( P > 0.05 for all).

CONCLUSIONS

Timing of surgery after OTA 13 A-C and 21 A-C elbow fractures was not associated with differences in postoperative complications or range of elbow motion.

LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.