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BMC Musculoskeletal Disorders

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Open Access 01-12-2015 | Research article

The effect of trauma and patient related factors on radial head fractures and associated injuries in 440 patients

Authors: Izaäk F. Kodde, Laurens Kaas, Nick van Es, Paul G.H. Mulder, C. Niek van Dijk, Denise Eygendaal

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Abstract

Background

Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the energy transferred during trauma has its influence on the risk on associated ipsilateral upper limb injuries. However, relationships between Mason classification, mechanism of injury, and associated injuries have been reported only once before in a relatively small population. The purpose of this study was to define whether trauma mechanism and patient related factors are of influence on the type of radial head fracture and associated injuries to the ipsilateral upper limb in 440 patients.

Methods

The radiographs and medical records of 440 patients that presented with a fracture of the radial head were retrospectively analyzed. The medical records of all patients were searched for (1) the trauma mechanism and (2) associated injuries of the ipsilateral upper limb. The mechanism of injury was classified as being low-energy trauma (LET) or high-energy trauma (HET).

Results

Associated injuries to the ipsilateral upper limb were present in 46 patients (11 %). The mean age of patients with associated injuries (52 years) was significantly higher compared to patients without associated injuries (47 years) (P = 0.038), and female patients with a radial head fracture were older than males. Injury patterns were classified as LET in 266 patients (60 %) and as HET in 174 patients. HETs were significantly more common in young men. Associated injuries were not significantly different distributed between HET versus LET (P = 0.82).

Conclusions

Injuries concomitant to radial head fractures were present in 11 % of patients and the risk for these associated injuries increases with age. Trauma mechanism did not have a significant influence on the risk of associated injuries. Complex elbow trauma in patients with a radial head fracture seems therefore to be suspected based on patient characteristics, rather than mechanism of injury.

Kaas L, van Riet RP, Vroemen JP, Eygendaal D. The epidemiology of radial head fractures. J Shoulder Elbow Surg. 2010;19(4):520–3. doi:10.1016/j.jse.2009.10.015.CrossRefPubMed

Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM. The epidemiology of radial head and neck fractures. J Hand Surg [Am]. 2012;37(1):112–9. doi:10.1016/j.jhsa.2011.09.034.CrossRef

Amis AA, Miller JH. The mechanisms of elbow fractures: an investigation using impact tests in vitro. Injury. 1995;26(3)):163–8. doi:10.1016/0020-1383(95)93494-3.CrossRefPubMed

Kaas L, Sierevelt IN, Vroemen JP, van Dijk CN, Eygendaal D. Osteoporosis and radial head fractures in female patients: a case–control study. J Shoulder Elbow Surg. 2012;21(11):1555–8. doi:10.1016/j.jse.2012.03.007.CrossRefPubMed

Itamura J, Roidis N, Mirzayan R, Vaishnav S, Learch T, Shean C. Radial head fractures: MRI evaluation of associated injuries. J Shoulder Elbow Surg. 2005;14(4):421–4. doi:10.1016/j.jse.2004.11.003.CrossRefPubMed

Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123–32. doi:doi.CrossRefPubMed

Morrey BF, An KN. Stability of the elbow: osseous constraints. J Shoulder Elbow Surg. 2005;14(1 Suppl S):174S–8S. doi:10.1016/j.jse.2004.09.031.CrossRefPubMed

Morrey BF. Current concepts in the management of complex elbow trauma. Surgeon. 2009;7(3):151–61. doi:10.1016/S1479-666X(09)80039-5.CrossRefPubMed

Kalicke T, Muhr G, Frangen TM. Dislocation of the elbow with fractures of the coronoid process and radial head. Arch Orthop Trauma Surg. 2007;127(10):925–31. doi:10.1007/s00402-007-0424-6.CrossRefPubMed

10.

Kaas L, van Riet RP, Turkenburg JL, Vroemen JP, van Dijk CN, Eygendaal D. Magnetic resonance imaging in radial head fractures: most associated injuries are not clinically relevant. J Shoulder Elbow Surg. 2011;20(8):1282–8. doi:10.1016/j.jse.2011.06.011.CrossRefPubMed

11.

Kaas L, van Riet RP, Vroemen JP, Eygendaal D. The incidence of associated fractures of the upper limb in fractures of the radial head. Strategies Trauma Limb Reconstr. 2008;3(2):71–4. doi:10.1007/s11751-008-0038-8.CrossRefPubMedPubMedCentral

12.

van Riet RP, Morrey BF. Documentation of associated injuries occurring with radial head fracture. Clin Orthop Relat Res. 2008;466(1):130–4. doi:10.1007/s11999-007-0064-8.CrossRefPubMedPubMedCentral

13.

McGinley JC, Hopgood BC, Gaughan JP, Sadeghipour K, Kozin SH. Forearm and elbow injury: the influence of rotational position. J Bone Joint Surg Am. 2003;85-A(12):2403–9.PubMed

14.

Gebauer M, Barvencik F, Mumme M, Beil FT, Vettorazzi E, Rueger JM, et al. Microarchitecture of the radial head and its changes in aging. Calcif Tissue Int. 2010;86(1):14–22. doi:10.1007/s00223-009-9304-0.CrossRefPubMed

15.

Tom SE, Adachi JD, Anderson Jr FA, Boonen S, Chapurlat RD, Compston JE, et al. Frailty and fracture, disability, and falls: a multiple country study from the global longitudinal study of osteoporosis in women. J Am Geriatr Soc. 2013;61(3):327–34. doi:10.1111/jgs.12146.CrossRefPubMedPubMedCentral

16.

Kaas L, Turkenburg JL, van Riet RP, Vroemen JP, Eygendaal D. Magnetic resonance imaging findings in 46 elbows with a radial head fracture. Acta Orthop. 2010;81(3):373–6. doi:10.3109/17453674.2010.483988.CrossRefPubMedPubMedCentral

17.

Rineer CA, Guitton TG, Ring D. Radial head fractures: loss of cortical contact is associated with concomitant fracture or dislocation. J Shoulder Elbow Surg. 2010;19(1):21–5. doi:10.1016/j.jse.2009.05.015.CrossRefPubMed

18.

Kovar FM, Jaindl M, Thalhammer G, Rupert S, Platzer P, Endler G, et al. Incidence and analysis of radial head and neck fractures. World J Orthop. 2013;4(2):80–4. doi:10.5312/wjo.v4.i2.80.CrossRefPubMedPubMedCentral

19.

Duckworth AD, Watson BS, Will EM, Petrisor BA, Walmsley PJ, Court-Brown CM, et al. Radial head and neck fractures: functional results and predictors of outcome. J Trauma. 2011;71(3):643–8. doi:10.1097/TA.0b013e3181f8fa5f.CrossRefPubMed

20.

Doornberg J, Elsner A, Kloen P, Marti RK, van Dijk CN, Ring D. Apparently isolated partial articular fractures of the radial head: prevalence and reliability of radiographically diagnosed displacement. J Shoulder Elbow Surg. 2007;16(5):603–8. doi:10.1016/j.jse.2006.10.015.CrossRefPubMed

21.

Hausmann JT, Vekszler G, Breitenseher M, Braunsteiner T, Vecsei V, Gabler C. Mason type-I radial head fractures and interosseous membrane lesions–a prospective study. J Trauma. 2009;66(2):457–61. doi:10.1097/TA.0b013e31817fdedd.CrossRefPubMed

Title: The effect of trauma and patient related factors on radial head fractures and associated injuries in 440 patients
Authors: Izaäk F. Kodde
Laurens Kaas
Nick van Es
Paul G.H. Mulder
C. Niek van Dijk
Denise Eygendaal
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-015-0603-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The effect of trauma and patient related factors on radial head fractures and associated injuries in 440 patients

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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