Functional results after treatment of radial head fractures
Authors:
Jozef Masár; Mária Stránska
Authors‘ workplace:
Department of orthopaedic surgery and traumatology, Jessenius faculty of medicine, Comenius university and Martin faculty Hospital, Martin, Slovakia
; Ortopedicko – traumatologická klinika JLF UK a MFN Martin
Published in:
Úraz chir. 16., 2008, č.1
Overview
Purpose of the study:
The authors present results of therapy in 30 patients with 31 fractures of radial head, with surgical intervention carried out between 2001 and 2005. The options of the treatment in both simple and combined fractures are analysed, indications for conservative therapy or surgical intervention and modes of surgery are discussed.
Material:
They evaluated 30 pacients with 31 radial head fractures. This group included 16 women and 14 men. Average age of women was 48 years (17-74 years), of men 42 years (21-71 years). Average follow-up was 29 months.
Methods:
The type of fractures, trauma origin and mechanism, as well as various osteofixation methods are described. In the above-mentione cases also the trauma – surgery interval (7.1 days on average) was monitored. The eavaluation of results was performed by Mayo Elbow Performance Score (MEPS).
Results:
Excellent results were achieved in 18 elbow fractures (58 %), good results in 8 (25,8 %) and satisfactory results in 5 cases (16,2 %). Poor results were not observed. Only in 3 patients deliberation of the elbow was necessery, after an interval of 7-12 months. This intervention led to a MEPS improvement of up to 60 to 80 pts.
Conclusions:
Suggesting a universally optimal therapy model is impossible. Comparing the results of different approaches the authors gained similar results. The authors prefer a proactive approach in therapy, which allows a shortening of the fixation period as well as an early start of functional therapy. Further research will concentrate on the follow-up of this patients group, especially with a view to development of posttraumatic arthrosis.
Key words:
radial head fractures, surgical therapy, functional results, Mayo elbow performance score.
Sources
1. ASHWOOD, N., BAIN, G.I., UNNI, R. Management of Mason-type III. radial head fractures with a tita-nium prosthesis, ligament repair and early mobilization. J. Bone Joint Surg. 2004, 86-A, 274–280.
2. BEINGESSNER, D.M., DUNNING, C.E., GOR-DON, K.D. et al. The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg. 2004, 86-A, 1730–1739.
3. BROBERG, R.A., MORREY, B.F. Results of treatment of fracture-dislocation of the elbow. Clin Orthop. 1987, 216, 109–119.
4. BRTKOVÁ, J., REJTAR, P., DĚDEK, P. et al. Zobrazovací metody při úrazech loketního kloubu. Acta Chir orthop Traum čech. 2005,72, 254–258.
5. HERBERTSSON, P., JOSEFSSON, P-O., HASSE-RIUS, R. et al. Uncomplicated Mason type II. and III. fractures of the radial head and neck in adults. J. Bone Joint Surg. 2004, 86-A, 569–574.
6. HERBERTSSON, P., JOSEFSSON, P-O., HASSERIUS, R. Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg. 2004, 86-A, 1925–1930.
7. IKEDA, M., OKA, Y. Function after early radial head resection for fracture. Acta orthop. Scand. 2000, 71, 191–194.
8. KASAL, T. Artroskopie loketního kloubu. In: DUNGL, P. (Ed.): Ortopedie. 1.vyd. Praha: Grada Publishing, 2005. 722–723.
9. KOPEČEK, P. Artroskopie loketního kloubu. Acta Chir orthop Traum Cech. 2004, 71, 292–296.
10. MALKUS, T. Obecná traumatologie. In : DUNGL, P. (Ed.): Ortopedie. 1. vyd. Praha: Grada Publishing 2005. 519–600.
11. MASON, M. L. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954, 42, 123–132.
12. MIKIC, Z.D., VUKADINOVIC, S.M. Late results in fractures of the radial head treated by excision. Clin Orthop. 1983, 181, 220–228.
13. MORREY, B.F., CHAO, E.Y., HUI, F.C. Biomechanical study of the elbow following excision of the radial head. J Bone Joint Surg. 1979, 61-A, 63–68.
14. MORREY, B.F., ADAMS, R.A. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg. 1992, 74-A,479–490.
15. RADIN, E.L., RISEBOROUGH, E.J. Fractures of the radial head. A review of eightyeight cases and analysis of the indications for excision of the radial head and non-operative treatment. J Bone Joint Surg. 1966, 48-A, 1055–1064.
16. REHÁK, P. Poranenia hornej končatiny. In: HUDEC, I. et al. (Ed.): Úrazová chirurgia. 1.vyd. Martin: Osveta 1986. 585–658.
17. TYPOVSKÝ, K., et al. Traumatologie pohybového ústrojí. 2. vyd. Praha: Avicenum, 1981. 551 s.
Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
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