ANALYSIS OF TREATMENT OUTCOMES IN PATIENTS WITH RADIAL HEAD FRACTURES
DOI:
https://doi.org/10.32689/2663-0672-2024-4-5Keywords:
fracture of the radial head, osteosynthesis, endoprosthesis, resection, treatmentAbstract
Radial head fractures are the most common and account for 2.8% of all fractures of the entire skeleton, ulnar and radial neck fractures occur in 1% of cases. The aim of our work was to determine the optimal model of surgical treatment of patients with radial head fractures. Materials and methods. Our study involved 73 patients with radial head fractures who were treated at the Regional Clinical hospital named after II Mechnikov, Dnipro, from 2020 to 2023. The first group included 17 patients with radial head fractures who underwent head removal. The second group included 38 patients who underwent open reduction and osteosynthesis of the radial head. The third group included 18 patients who underwent radial head arthroplasty. Results. Among the patients of the general array, Mason-Hotchkiss type II fractures were most common and were detected in 42.5% of cases. In 31.5% of the patients of the general array, type III damage to the radial head was detected. Type I damage was the least common, which was detected in 26.0%. An excellent result of treatment according to the MEPS scale was most often detected among the patients of the third group. This result was observed in 38.9% of the patients of this group. Good results according to the MEPS scale were most often observed in the second group. Such a result of treatment of fractures of the radial head was registered in 47.4% of the patients of the second group. The assessment of the treatment result as “satisfactory” was detected in 47.1% of the patients of the first group. Patients with an unsatisfactory result according to the MEPS scale were most often detected in the first group, where they were registered in 23.5% of cases. Conclusions. According to our study, radial head arthroplasty in patients with isolated radial head fractures showed better clinical outcomes and patient satisfaction. Therefore, radial head arthroplasty may be a better treatment option for patients with such injuries, especially in cases of Mason.
References
Bökeler U. W., Kraft F., Schappacher R., Weisenberger V., Herlan A., Liener U. C. Langzeitverlauf und Einflussfaktoren auf das Outcome nach endoprothetischem Ersatz des Radiuskopfes bei nichtrekonstruierbaren Frakturen [Radial head arthropolasty in unreconstructable comminuted fractures of the radial head: Long-term results and factors influencing the outcome]. Unfallchirurgie (Heidelb). 2023 Mar. 126 (3), 218–226. German. doi: 10.1007/s00113-021-01139-8. Epub 2022 Jan 25. PMID: 35076716.
Breulmann F. L., Lappen S., Ehmann Y., Bischofreiter M., Lacheta L., Siebenlist S. Treatment strategies for simple elbow dislocation – a systematic review. BMC Musculoskelet Disord. 2024 Feb 16. 25 (1), 148. doi: 10.1186/s12891-024-07260-0. PMID: 38365699; PMCID: PMC10874000.
Chen A. C., Chou Y. C., Weng C. J., Cheng C. Y. Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures. J Orthop Surg Res. 2018 Jun 1. 13 (1), 134. doi: 10.1186/s13018-018-0844-8. PMID: 29859102; PMCID: PMC5984821.
Cristofaro C. D., Carter T. H., Wickramasinghe N. R., McQueen M. M., White T. O., Duckworth A. D. High Risk of Further Surgery After Radial Head Replacement for Unstable Fractures: Longer-term Outcomes at a Minimum Follow-up of 8 Years. Clin Orthop Relat Res. 2019 Nov. 477 (11), 2531–2540. doi: 10.1097/CORR.0000000000000876. PMID: 31389899; PMCID: PMC6903861.
Giannicola G., Di Sante L., Corsi G., Zoccali C., Prigent S., Cinotti G., Sessa P. The Prevalence of Chronic Interosseous Membrane Lesions Following Mason II and III Radial Head Fractures in Complex Elbow Instability-A Retrospective Observational Cohort Study. Healthcare (Basel). 2024 Sep 19. 12 (18), 1875. doi: 10.3390/healthcare12181875. PMID: 39337216; PMCID: PMC11431679.
Kim B. S., Cho C. H. Radial head resection versus replacement for unreconstructable radial head fractures. Clin Shoulder Elb. 2020 Sep 1. 23 (3), 117–118. doi: 10.5397/cise.2020.00234. PMID: 33330244; PMCID: PMC7714293.
Lópiz Y., González A., García-Fernández C., García-Coiradas J., Marco F. Comminuted fractures of the radial head: resection or prosthesis? Injury. 2016 Sep. 47 Suppl 3, S29–S34. doi: 10.1016/S0020-1383(16)30603-9. PMID: 27692103.
Martín Fuentes A. M., Ramos Pascua L. R., Cecilia López D. Correlation between radiographic findings and clinical failure in monopolar radial head replacement. Arch Orthop Trauma Surg. 2020 Jan. 140 (1), 51–58. doi: 10.1007/s00402-019-03273-w. Epub 2019 Sep 12. PMID: 31515620.
Ring D. CORR Insights®: High Risk of Further Surgery After Radial Head Replacement for Unstable Fractures: Longer-term Outcomes at a Minimum Follow-up of 8 Years. Clin Orthop Relat Res. 2019 Nov. 477 (11), 2541–2543. doi: 10.1097/CORR.0000000000000913. PMID: 31389886; PMCID: PMC6903847.
Sinha S., Sarkar S., Singh A., Saraf S. K., Rastogi A., Singh T. Radial Head Arthroplasty, Excision and Osteosynthesis in Complex Elbow Fracture-Dislocations in Young Adults: What is Preferred? Indian J Orthop. 2020 May 18, 54(Suppl 2), 260–269. doi: 10.1007/s43465-020-00136-0. PMID: 33194100; PMCID: PMC7609614.
