BACKGROUND: Complex radial head fractures treated by early resection arthroplasty yield good clinical results at long-term follow-up. METHODS: Fifty-one radial head excisions were performed for the treatment of radial head fractures. Twenty-seven patients (20 men, 7 women) were retrospectively reviewed. The mean age was 37 (range, 18-61) and their fracture types according to the Mason classification were 5 type II, 16 type III, and 6 type IV. The mean follow-up period was 17 years (range, 10-24). Patients were clinically evaluated: Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), visual analogue scale (VAS) for pain scores, and strength. Degenerative changes, proximal migration of the radius, and carrying angle were measured. RESULTS: The overall outcome of the MEPS was 96.4 (range, 70-100), 22 patients (81%) achieving an excellent result, 4 patients a good (15%), and 1 patient a fair result (4%). The mean DASH score was 4.89, with slightly better results in the Mason II group than the Mason III and IV patients (P = .15). VAS averaged 0.48 (range, 0-10). Twenty-three patients (85%) reported no pain. The mean range of motion was from 5° to 135°. Pronation averaged 83° and supination averaged 79°. Strength was maintained in 24 cases (88%). In 24 patients, osteoarthritic changes were present without clinical relevance. Proximal migration of the radius was recorded in 7 cases. Carrying angle increased significantly by 7° (15° compared with 8°). CONCLUSION: Radial head fractures treated by early resection arthroplasty offer satisfactory functional results in 96% of patients at long-term follow-up, in spite of the radiographic degenerative changes present in the great majority of cases.
BACKGROUND: Complex radial head fractures treated by early resection arthroplasty yield good clinical results at long-term follow-up. METHODS: Fifty-one radial head excisions were performed for the treatment of radial head fractures. Twenty-seven patients (20 men, 7 women) were retrospectively reviewed. The mean age was 37 (range, 18-61) and their fracture types according to the Mason classification were 5 type II, 16 type III, and 6 type IV. The mean follow-up period was 17 years (range, 10-24). Patients were clinically evaluated: Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), visual analogue scale (VAS) for pain scores, and strength. Degenerative changes, proximal migration of the radius, and carrying angle were measured. RESULTS: The overall outcome of the MEPS was 96.4 (range, 70-100), 22 patients (81%) achieving an excellent result, 4 patients a good (15%), and 1 patient a fair result (4%). The mean DASH score was 4.89, with slightly better results in the Mason II group than the Mason III and IV patients (P = .15). VAS averaged 0.48 (range, 0-10). Twenty-three patients (85%) reported no pain. The mean range of motion was from 5° to 135°. Pronation averaged 83° and supination averaged 79°. Strength was maintained in 24 cases (88%). In 24 patients, osteoarthritic changes were present without clinical relevance. Proximal migration of the radius was recorded in 7 cases. Carrying angle increased significantly by 7° (15° compared with 8°). CONCLUSION: Radial head fractures treated by early resection arthroplasty offer satisfactory functional results in 96% of patients at long-term follow-up, in spite of the radiographic degenerative changes present in the great majority of cases.
Authors: Pierre Laumonerie; Meagan E Tibbo; Panagiotis Kerezoudis; Marc Olivier Gauci; Nicolas Reina; Nicolas Bonnevialle; Pierre Mansat Journal: Int Orthop Date: 2018-07-30 Impact factor: 3.075
Authors: Andrew D Duckworth; Neil R Wickramasinghe; Nicholas D Clement; Charles M Court-Brown; Margaret M McQueen Journal: Clin Orthop Relat Res Date: 2014-07 Impact factor: 4.176
Authors: Caroline D Cristofaro; Thomas H Carter; Neil R Wickramasinghe; Margaret M McQueen; Timothy O White; Andrew D Duckworth Journal: Clin Orthop Relat Res Date: 2019-11 Impact factor: 4.176
Authors: Martin Kiechle; Andreas Thannheimer; Sven Hungerer; Jan Friederichs; Volker Bühren; Christian Von Rüden Journal: Arch Bone Jt Surg Date: 2019-03