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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

Long-term results after non-operative and operative treatment of radial neck fractures in adults

Authors: Holger Keil, Marc Schnetzke, Arpine Kocharyan, Sven Yves Vetter, Nils Beisemann, Benedict Swartman, Paul-Alfred Grützner, Jochen Franke

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

The aim of this study is to determine the functional long-term outcome after non-operative and operative treatment of radial neck fractures in adults.

Methods

Thirty-four consecutive patients with a mean age of 46.4 (18.0 to 63.0) years with a fracture of the radial neck who were treated between 2000 and 2014 were examined regarding the clinical and radiological outcome. Twenty patients were treated non-operatively, and 14 patients underwent surgery.

Results

After a mean follow-up of 5.7 (2.0 to 15.7) years, the clinical scores showed good results in both groups. The Disabilities of Arm, Shoulder and Hand score was 16.1 (0 to 71.6) in the non-operative group and 8.8 (0 to 50.8) in the operative group, respectively. The Mayo Elbow Performance Score was 80.0 (30 to 95) in the non-operative group and 82.5 (35 to 95) in the non-operative group, respectively. The initial angle of the radial head towards the shaft (RHSA) was significantly higher in the operative group in the anterior-posterior plane (12.8° [2 to 23] vs. 26.3° [1 to 90], p = 0.015). In the follow-up radiographs, the RHSA was significantly lower in the operative group (15.1° [3 to 30] vs. 10.9° [3 to 18], p = 0.043). Five patients developed 7 complications in the non-operative group, and 7 patients developed 12 complications in the operative group. Revision rates were higher in the operative groups as 1 patient received radial head resection in the non-operative (5%) group while 7 patients in the operative group (50%) needed revision surgery.

Conclusion

A good functional long-term outcome can be expected after operative and non-operative treatment of radial neck fractures in adults. If needed due to major displacement, open reduction is associated with a higher risk of complications and the need for revision surgery but can achieve similar clinical results.

Trial registration

DRKS DRKS00012836 (retrospectively registered)
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Metadata
Title
Long-term results after non-operative and operative treatment of radial neck fractures in adults
Authors
Holger Keil
Marc Schnetzke
Arpine Kocharyan
Sven Yves Vetter
Nils Beisemann
Benedict Swartman
Paul-Alfred Grützner
Jochen Franke
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0731-3

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