ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Short term outcomes of civilian ballistic distal humeral fractures compared with blunt open and closed distal humeral fractures.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe objective of this study was to assess outcomes of ballistic distal humeral fracture in comparison with open and closed distal humeral fractures sustained via blunt mechanisms.
designRetrospective cohort study.
settingAcademic Level I trauma center.
participantsSkeletally mature patients presenting with ballistic (17), blunt open (36), or blunt closed (94) distal humeral shaft fractures (AO/OTA 13A-C). MAIN OUTCOMES: Number of unplanned reoperations, intensive care unit admission, persistent ulnar nerve neuropathy, nonunion, superficial infection, deep infection, heterotopic ossification formation, hardware removal, and length of stay.
resultsA total of 147 distal humeral fractures that underwent operative fixation were included in the study. A group of 17 ballistic fractures and comparison groups of 36 open and 94 closed distal humeral fractures sustained via blunt mechanisms was identified. Compared with the blunt closed group, the ballistic group had a higher proportion vascular injury (p = 0.001), preoperative ulnar nerve injury (p < 0.001), and longer operative times (p = 0.007). Compared with the blunt open group, the ballistic group sustained a higher proportion of preoperative ulnar nerve injuries (p = 0.012), required less olecranon osteotomies (p = 0.045), and had fewer unplanned reoperations (p = 0.043).
conclusionBallistic distal humerus fractures sustain high rates of neurologic and vascular injury but have similar short term outcomes to blunt closed fractures. LEVEL OF EVIDENCE: Prognostic Level III.
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