Fractures of the elbow joint are quite rare compared with the total in
cidence of injuries to the extremities. However, elbow fractures often
result in significant disability. Therefore in a retrospective study,
we have evaluated criteria that are of prognostic value for late func
tional outcome. Sixty-four (10.3%) of 622 patients with closed elbow f
ractures and 107 (89%) of 119 patients with open elbow fractures under
went a physical examination. The mean follow-up time was 8.2 years. Th
e functional outcome was recorded by a modified score (0 - max. 15) ac
cording to Morrey. Epidemiological data from both groups revealed a gr
eater severity and higher degree of injury in open fractures than in c
losed fractures. In contrast, both groups presented a comparably good
functional result. The most significant factor for poor outcome (score
<5) was identified as nerve lesions. Among all nerve lesions in open
fractures, 45% resulted in a functional score of <5; in 32% of closed
fractures combined with a nerve lesion a similarly poor result was als
o noted. A second major factor appeared to be the method of primary th
erapy. An external joint transfixation resulted in a score of <5 in 32
% of patients that were treated primarily by transfixation. In cases i
nitially treated with open reduction and internal fixation, only 18.5%
of open fractures and 3.1% of closed fractures presented a similar lo
w score. According to our results the late functional outcome of elbow
fractures depends less on the type of fracture than on the presence o
f a nerve lesion and the method of primary treatment, which should fac
ilitate early mobilization.