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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2019 | Radial Head Fracture | Research article

Severe traumatic valgus instability of the elbow: pathoanatomy and outcomes of primary operation

Authors: Lei Zhang, Laixu Wang, Shiyang Yu, Zhanhui Lv, Peng Zhang, Cunyi Fan, Yixin Shen

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Abstract

Background

The objective of the study was to depict the pathoanatomy of traumatic valgus instability of the elbow and to report clinical outcomes of primary operation.

Methods

Thirty-one patients presented with traumatic valgus instability of the elbow without dislocation. Thirty-one patients underwent surgical intervention of radial head fractures (28 open reduction and internal fixation and 3 radial head resection) and anatomical repair of the anterior bundle of medial collateral ligament (AMCL) with suture anchors. Twenty patients with disruption of the flexor-pronator tendon (FPT) and 14 patients with tears of the anterior capsule had primary repair of the FPT and anterior capsule simultaneously. Clinical outcomes were evaluated with the Mayo Elbow Performance Score (MEPS), modified hospital for special surgery assessment scale (HSS), and Disabilities of the Arm, Shoulder, and Hand (DASH) score.

Results

The median follow-up was 37.3 months (range, 15–53 months). Radial head fractures and complete avulsion of the medial collateral ligament (MCL) from its humeral footprint were confirmed in all patients intraoperatively. Intraoperative findings indicated disruption of the FPT in 20 patients and tears of the anterior capsule in 14 patients. Twenty-nine of 31 patients returned to previous activity and work levels within 6 months after surgery. The MEPS, modified HSS, and DASH score were 94 ± 4, 91 ± 5, and 8 ± 2 at the latest follow-up.

Conclusions

Radial head fractures with avulsion of the MCL can lead to severe valgus instability of the elbow. Primary operation to repair these disrupted structures, especially repair of the AMCL, can effectively restore valgus stability.

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Title: Severe traumatic valgus instability of the elbow: pathoanatomy and outcomes of primary operation
Authors: Lei Zhang
Laixu Wang
Shiyang Yu
Zhanhui Lv
Peng Zhang
Cunyi Fan
Yixin Shen
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Radial Head Fracture
Radial Head Fracture
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-019-1374-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe traumatic valgus instability of the elbow: pathoanatomy and outcomes of primary operation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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