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Published in: International Orthopaedics 8/2015

01-08-2015 | Original Paper

Open reduction and internal fixation versus radial head arthroplasty in the treatment of adult closed comminuted radial head fractures (modified Mason type III and IV)

Authors: Salah Al-Burdeni, Yousef Abuodeh, Talal Ibrahim, Ghalib Ahmed

Published in: International Orthopaedics | Issue 8/2015

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Abstract

Background

The purpose of our study was to compare the outcome of radial head fractures (modified Mason type III and IV) treated by open reduction and internal fixation (ORIF) versus radial head arthroplasty (RHA).

Patients and methods

A retrospective review of 36 patients with closed comminuted radial head fractures treated either by ORIF or RHA with an average of 15-months’ follow-up was undertaken. The primary outcome was the QuickDASH, the shortened version of the Dissabilities of the Arm, Shouler and Hand score. Other outcomes included regain of functional range of motion (ROM) of the elbow and duration of surgery. Surgical complications were noted.

Results

Thirty-six patients with a mean age of 36 years were evaluated. Nineteen patients underwent ORIF and 17 RHA. The two treatment groups were comparable with regards to gender, side of injury, Mason type and mechanism of injury. Patients who underwent RHA were slightly older (p < 0.001). At follow-up, the QuickDASH score was similar between groups (p = 0.58). Regain of functional ROM of the elbow (p = 0.13) and complication rate (p = 0.57) were similar.

Conclusion

The treatment of closed comminuted radial head fracture (modified Mason type III and IV) with ORIF and RHA demonstrates similar findings despite less surgical time for performing RHA.
Literature
1.
go back to reference Holmenschlager F, Halm JP, Winckler S (2002) Fresh fractures of the radial head: results with the Judet prosthesis. Rev Chir Orthop Reparatrice Appar Mot 88:387–397, FrenchPubMed Holmenschlager F, Halm JP, Winckler S (2002) Fresh fractures of the radial head: results with the Judet prosthesis. Rev Chir Orthop Reparatrice Appar Mot 88:387–397, FrenchPubMed
2.
go back to reference Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJ (2004) The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am 86:1730–1739PubMed Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJ (2004) The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am 86:1730–1739PubMed
3.
go back to reference Morrey BF (ed) (2000) Radial head fracture. In: The elbow and its disorders. 3rd edn. WB Saunders, Philadelphia, 341–364 Morrey BF (ed) (2000) Radial head fracture. In: The elbow and its disorders. 3rd edn. WB Saunders, Philadelphia, 341–364
4.
go back to reference Ikeda M, Yamashina Y, Kamimoto M, Oka Y (2003) Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates. J Bone Joint Surg Br 85:1040–1044PubMedCrossRef Ikeda M, Yamashina Y, Kamimoto M, Oka Y (2003) Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates. J Bone Joint Surg Br 85:1040–1044PubMedCrossRef
5.
go back to reference King GJ, Evans DC, Kellam JF (1991) Open reduction and internal fixation of radial head fractures. J Orthop Trauma 5:21–28PubMedCrossRef King GJ, Evans DC, Kellam JF (1991) Open reduction and internal fixation of radial head fractures. J Orthop Trauma 5:21–28PubMedCrossRef
6.
go back to reference Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815PubMed Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815PubMed
7.
go back to reference Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJ (2005) Kinematics and stability of the fractured and implant-reconstructed radial head. J Shoulder Elbow Surg 14(suppl 1):195S–201SPubMedCrossRef Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJ (2005) Kinematics and stability of the fractured and implant-reconstructed radial head. J Shoulder Elbow Surg 14(suppl 1):195S–201SPubMedCrossRef
8.
go back to reference Bain GI, Ashwood N, Baird R, Unni R (2005) Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization: surgical technique. J Bone Joint Surg Am 87(suppl 1):136–147PubMed Bain GI, Ashwood N, Baird R, Unni R (2005) Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization: surgical technique. J Bone Joint Surg Am 87(suppl 1):136–147PubMed
9.
go back to reference Morrey BF, Chao EY, Hui FC (1979) Biomechanical study of the elbow following excision of the radial head. J Bone Joint Surg Am 61:63–68PubMed Morrey BF, Chao EY, Hui FC (1979) Biomechanical study of the elbow following excision of the radial head. J Bone Joint Surg Am 61:63–68PubMed
10.
go back to reference Rymaszewski LA, Mackay I, Amis AA, Miller JH (1984) Long-term effects of excision of the radial head in rheumatoid arthritis. J Bone Joint Surg Br 66:109–113PubMed Rymaszewski LA, Mackay I, Amis AA, Miller JH (1984) Long-term effects of excision of the radial head in rheumatoid arthritis. J Bone Joint Surg Br 66:109–113PubMed
11.
go back to reference Esser RD, Davis S, Taavao T (1995) Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma 9:318–323PubMedCrossRef Esser RD, Davis S, Taavao T (1995) Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma 9:318–323PubMedCrossRef
12.
go back to reference McArthur RA (1987) Herbert screw fixation of fracture of the head of the radius. Clin Orthop Relat Res 224:79–87PubMed McArthur RA (1987) Herbert screw fixation of fracture of the head of the radius. Clin Orthop Relat Res 224:79–87PubMed
13.
go back to reference Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132PubMedCrossRef Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132PubMedCrossRef
14.
go back to reference Knight DJ, Rymaszewski LA, Amis AA, Miller JH (1993) Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br 75:572–576PubMed Knight DJ, Rymaszewski LA, Amis AA, Miller JH (1993) Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br 75:572–576PubMed
16.
go back to reference Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ (2001) Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am 83:1201–1211PubMed Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ (2001) Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am 83:1201–1211PubMed
17.
go back to reference Chen X, Wang SC, Cao LH, Yang GQ, Li M, Su JC (2011) Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop 35:1071–1076PubMedCentralPubMedCrossRef Chen X, Wang SC, Cao LH, Yang GQ, Li M, Su JC (2011) Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop 35:1071–1076PubMedCentralPubMedCrossRef
18.
go back to reference Schnetzke M, Aytac S, Deuss M, Studier-Fischer S, Swartman B, Muenzberg M, Gruetzner PA, Guehring T (2014) Radial head prosthesis in complex elbow dislocations: effect of oversizing and comparison with ORIF. Int Orthop 38:2295–2301PubMedCrossRef Schnetzke M, Aytac S, Deuss M, Studier-Fischer S, Swartman B, Muenzberg M, Gruetzner PA, Guehring T (2014) Radial head prosthesis in complex elbow dislocations: effect of oversizing and comparison with ORIF. Int Orthop 38:2295–2301PubMedCrossRef
19.
go back to reference Ruan HJ, Fan CY, Liu JJ, Zeng BF (2009) A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III. Int Orthop 33:249–253PubMedCentralPubMedCrossRef Ruan HJ, Fan CY, Liu JJ, Zeng BF (2009) A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III. Int Orthop 33:249–253PubMedCentralPubMedCrossRef
20.
go back to reference Mancini GB, Fiacca C, Picuti G (1989) Resection of the radial capitellum. Long- term results. Ital J Orthop Traumatol 15:295–302PubMed Mancini GB, Fiacca C, Picuti G (1989) Resection of the radial capitellum. Long- term results. Ital J Orthop Traumatol 15:295–302PubMed
21.
go back to reference Mikic ZD, Vukadinovic SM (1983) Late results in fractures of the radial head treated by excision. Clin Orthop Relat Res 181:220–228PubMed Mikic ZD, Vukadinovic SM (1983) Late results in fractures of the radial head treated by excision. Clin Orthop Relat Res 181:220–228PubMed
22.
go back to reference Coleman DA, Blair WF, Shurr D (1987) Resection of the radial head for fracture of the radial head, long-term follow up for seventeen cases. J Bone Joint Surg Am 69:385–392PubMed Coleman DA, Blair WF, Shurr D (1987) Resection of the radial head for fracture of the radial head, long-term follow up for seventeen cases. J Bone Joint Surg Am 69:385–392PubMed
23.
go back to reference Postacchini F, Morace GB (1992) Radial head fracture treated by resection. Long-term results. Ital J Orthop Traumatol 18:323–330PubMed Postacchini F, Morace GB (1992) Radial head fracture treated by resection. Long-term results. Ital J Orthop Traumatol 18:323–330PubMed
24.
go back to reference Janssen RP, Vegter J (1998) Resection of the radial head after Mason type-III fractures of the elbow: follow-up at 16 to 30 years. J Bone Joint Surg Br 80:231–233PubMedCrossRef Janssen RP, Vegter J (1998) Resection of the radial head after Mason type-III fractures of the elbow: follow-up at 16 to 30 years. J Bone Joint Surg Br 80:231–233PubMedCrossRef
25.
go back to reference Goldberg I, Peyland J, Yosipovitch Z (1986) Late results of the excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 68:675–679PubMed Goldberg I, Peyland J, Yosipovitch Z (1986) Late results of the excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 68:675–679PubMed
Metadata
Title
Open reduction and internal fixation versus radial head arthroplasty in the treatment of adult closed comminuted radial head fractures (modified Mason type III and IV)
Authors
Salah Al-Burdeni
Yousef Abuodeh
Talal Ibrahim
Ghalib Ahmed
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 8/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2755-1

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