Outcome Measures Utilized in the Capitellum and Trochlea Fracture Literature: A Systematic Review

Abstract

Purpose: This study aimed to evaluate the outcome measures that the current isolated capitellar and trochlear fracture literature has used. Methods: A systematic literature review identified capitellar and/or trochlear fracture treatment articles published between January 1, 2006 and December 31, 2016. Exclusion criteria included review articles, meta-analyses, technique articles, and biomechanical/anatomic studies. Included studies were reviewed for patient demographics and reports of range of motion, outcome measures, satisfaction rate, return to previous level of activity, complication rate, and reoperation rate. The use of different outcome measures was compared among smaller and larger case series and in journals with higher and lower impact factors. Results: Of 285 articles, 45 met inclusion criteria. Mean number of capitellum and/or trochlea fractures per study was 11.3 (mean patient age, 34.6 years). Average follow-up was 29.4 months. Eight outcome measures were used, the most common of which were the Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand/Quick–Disabilities of the Arm, Shoulder, and Hand, and American Shoulder and Elbow Surgeons scores. An average of 1.09 outcome measures were reported per study; 15% of studies reported a satisfaction rate. Larger studies were associated with more outcome measures and used the MEPS more often. Studies in journals with an impact factor of 1 or greater had more patients, more reported outcome scores, and higher use of the MEPS compared with studies with an impact factor of less than 1. Conclusions: Capitellum and trochlea fracture studies have major outcome-measure reporting inconsistencies. The MEPS is the most frequently reported measure. Higher-level journals and studies with 5 or more fractures reported more outcome scores. Future studies should include commonly reported outcome measures to allow for cross-study comparison. Type of study/level of evidence: Therapeutic IV. Key words: capitellum fracture, cross-study comparison, MEPS, outcome measures, trochlea fracture