BACKGROUND: Aim of this study was to compare the clinical and radiological long-term outcomes following operative treatment of comminuted radial head fractures using 1) primary radial head resection arthroplasty, 2) acute radial head resection, or 3) necessary secondary prosthetic removal. Additionally, we evaluated complex radial head fractures combined with elbow dislocation and verified the hypothesis of whether primary radial head resection arthroplasty could contribute to ligament healing. METHODS: In a comparative retrospective cohort study between 2004 and 2014, 87 (33 female, 54 male) patients with comminuted radial head fractures with a median age of 45 (range 18-77) years were included and followed-up clinically and radiologically. Functional results were evaluated according to MEPS, DASH, Broberg and Morrey, and VAS scores. RESULTS: After a median range of 46 months postoperatively, 48 patients (group 1) obtained an acute radial head resection arthroplasty (MEPS: 70 points, Broberg and Morrey: 63 points, DASH: 34 points, VAS: 3.3 points). Twenty patients (group 2) were treated by radial head resection (MEPS: 63 points, Broberg and Morrey: 50 points, DASH: 49 points, VAS 4.2 points) and 19 patients (group 3) needed secondary prosthesis removal (MEPS: 73 points, Broberg and Morrey: 66 points, DASH: 38 points, VAS: 2.8 points). The overall outcome demonstrated a trend towards better results and the Kellgren-Lawrence grade of postoperative osteoarthritis was significantly better in groups 1 and 3 compared to group 2 (P=0.02). CONCLUSION: Clinical and radiological long-term results of this study demonstrate a trend towards a better outcome after acute radial head resection arthroplasty compared to primary radial head resection, especially in complex fractures associated with elbow dislocation. Furthermore, our results encourage the use of primary radial head replacement in cases of comminuted non-reconstructable radial head fractures.
BACKGROUND: Aim of this study was to compare the clinical and radiological long-term outcomes following operative treatment of comminuted radial head fractures using 1) primary radial head resection arthroplasty, 2) acute radial head resection, or 3) necessary secondary prosthetic removal. Additionally, we evaluated complex radial head fractures combined with elbow dislocation and verified the hypothesis of whether primary radial head resection arthroplasty could contribute to ligament healing. METHODS: In a comparative retrospective cohort study between 2004 and 2014, 87 (33 female, 54 male) patients with comminuted radial head fractures with a median age of 45 (range 18-77) years were included and followed-up clinically and radiologically. Functional results were evaluated according to MEPS, DASH, Broberg and Morrey, and VAS scores. RESULTS: After a median range of 46 months postoperatively, 48 patients (group 1) obtained an acute radial head resection arthroplasty (MEPS: 70 points, Broberg and Morrey: 63 points, DASH: 34 points, VAS: 3.3 points). Twenty patients (group 2) were treated by radial head resection (MEPS: 63 points, Broberg and Morrey: 50 points, DASH: 49 points, VAS 4.2 points) and 19 patients (group 3) needed secondary prosthesis removal (MEPS: 73 points, Broberg and Morrey: 66 points, DASH: 38 points, VAS: 2.8 points). The overall outcome demonstrated a trend towards better results and the Kellgren-Lawrence grade of postoperative osteoarthritis was significantly better in groups 1 and 3 compared to group 2 (P=0.02). CONCLUSION: Clinical and radiological long-term results of this study demonstrate a trend towards a better outcome after acute radial head resection arthroplasty compared to primary radial head resection, especially in complex fractures associated with elbow dislocation. Furthermore, our results encourage the use of primary radial head replacement in cases of comminuted non-reconstructable radial head fractures.
Entities:
Keywords:
Broberg and Morrey; DASH; Outcome; Radial head fracture; Radial head resection arthroplasty
Authors: Ruby Grewal; Joy C MacDermid; Kenneth J Faber; Darren S Drosdowech; Graham J W King Journal: J Bone Joint Surg Am Date: 2006-10 Impact factor: 5.284
Authors: Anneluuk L C Lindenhovius; Quinten Felsch; Job N Doornberg; David Ring; Peter Kloen Journal: J Hand Surg Am Date: 2007 May-Jun Impact factor: 2.230
Authors: Pär Herbertsson; Per Olof Josefsson; Ralph Hasserius; Jack Besjakov; Fredrik Nyqvist; Magnus K Karlsson Journal: J Bone Joint Surg Am Date: 2004-09 Impact factor: 5.284
Authors: Agung Riyanto Budi Santoso; Thomas Erwin Christian Junus Huwae; Dedde Aditya Rachman; Marvin Anthony Putera Journal: Int J Surg Case Rep Date: 2020-05-08