The outcomes of surgical treatment of complex radial head fractures.
Humans
Male
Female
Radius Fractures
/ surgery
Middle Aged
Adult
Fracture Fixation, Internal
/ methods
Range of Motion, Articular
Treatment Outcome
Elbow Joint
/ surgery
Open Fracture Reduction
/ methods
Retrospective Studies
Follow-Up Studies
Aged
Propensity Score
Arthroplasty
/ methods
Young Adult
Radial Head and Neck Fractures
Journal
The bone & joint journal
ISSN: 2049-4408
Titre abrégé: Bone Joint J
Pays: England
ID NLM: 101599229
Informations de publication
Date de publication:
01 Oct 2024
01 Oct 2024
Historique:
medline:
1
10
2024
pubmed:
1
10
2024
entrez:
30
9
2024
Statut:
epublish
Résumé
The aim of this study was to evaluate the outcome of complex radial head fractures at mid-term follow-up, and determine whether open reduction and internal fixation (ORIF) or radial head arthroplasty (RHA) should be recommended for surgical treatment. Patients who underwent surgery for complex radial head fractures (Mason type III, ≥ three fragments) were divided into two groups (ORIF and RHA) and propensity score matching was used to individually match patients based on patient characteristics. Ultimately, 84 patients were included in this study. After a mean follow-up of 4.1 years (2.0 to 9.5), patients were invited for clinical and radiological assessment. The Mayo Elbow Performance Score (MEPS), Oxford Elbow Score (OES), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score were evaluated. Patients treated with ORIF showed significantly better postoperative range of motion for flexion and extension (121.1° (SD 16.4°) vs 108.1° (SD 25.8°); p = 0.018). Postoperative functional scores also showed significantly better results in the ORIF group (MEPS 90.1 (SD 13.6) vs 78 (SD 20.5); p = 0.004). There was no significant difference between the groups in terms of the complication rate (RHA 23.8% (n = 10) vs ORIF 26.2% (n = 11)). Implant-related complications occurred in six cases (14.3%) in the RHA group and in five cases (11.9%) in the ORIF group. Irrespective of the patient's age, sex, type of injury, or number of fracture fragments, ORIF of the radial head should be attempted initially, if a stable reconstruction can be achieved, as it seems to provide a superior postoperative outcome for the patient compared to primary RHA. If reconstruction is not feasible, RHA is still a viable alternative. In the surgical treatment of complex radial head fractures, reconstruction shows superior postoperative outcomes compared to RHA. Good postoperative results can be achieved even after failed reconstruction and conversion to secondary RHA. Therefore, we encourage surgeons to favour reconstruction of complex radial head fractures, regardless of injury type or number of fragments, as long as a stable fixation can be achieved.
Identifiants
pubmed: 39348918
doi: 10.1302/0301-620X.106B10.BJJ-2024-0407.R1
pii: BJJ-2024-0407.R1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1158-1164Informations de copyright
© 2024 The British Editorial Society of Bone & Joint Surgery.
Déclaration de conflit d'intérêts
None declared.
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