Documentation of Associated Injuries Occurring With Radial Head Fracture

Riet, Roger P. van; Morrey, B.F.

doi:10.1007/s11999-007-0064-8

Cited by 139 publications

(71 citation statements)

References 35 publications

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“…Radial head fractures can occur in isolation or with associated elbow and forearm injuries, including fractures, fracturedislocations, and/or ligamentous injuries [9,11,32,35]. Options for treatment include nonoperative management [1,20], fragment or whole-head excision [6,15,21,24,30], open reduction and internal fixation (ORIF) [2,13,25,26,28], and radial head arthroplasty [7,8,10,14,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Open Reduction and Internal Fixation of Radial Head Fractures: Do Outcomes Differ Between Simple and Complex Injuries?

Pike

Grewal

Athwal

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Radial head fractures can occur in isolation or in association with elbow and forearm injuries. Treatment options include nonoperative management, fragment or whole-head excision, open reduction and internal fixation (ORIF), and radial head arthroplasty. However, the evidence supporting ORIF for repairable radial head fractures is inconclusive. Questions/purposes We compared patients undergoing ORIF for isolated radial head fractures or for radial head fractures associated with other fractures or elbow dislocations in terms of patient-related disability, presence of posttraumatic arthritis, complications, and rate of reoperation for capsular release. Methods Between 1997 and 2008, 52 patients underwent ORIF of the radial head for isolated radial head fractures (simple group) and 29 underwent ORIF for radial head fracture with an associated fracture or dislocation (complex group). General indications for ORIF included displaced radial fractures, large articular surface fragments, and greater than 2 mm of displacement and/or a mechanical block to forearm rotation or associated fractures or ligament injuries requiring surgery. Thirty-one patients (60%) in the simple group and 20 (69%) in the complex group were available for followup at a mean of 4 years (range, 1.0-9.5 years). We evaluated the patients using a validated self-reported pain and disability questionnaire (Patientrated Elbow Evaluation [PREE]). Records review included radiographic examination and assessment of major complications and secondary surgery rates for capsular release. Results With the numbers available, the groups were not different in terms of the mean PREE scores (8 versus 15 for the simple and complex groups, respectively; p = 0.13, lower values indicate lower pain and disability). The simple and complex groups were also not different with the numbers available in terms of major complications (13% versus 25%, respectively; p = 0.29) or secondary capsular release (3% versus 20%, respectively; p = 0.07). Conclusions At short term, we found no differences between patients treated with ORIF for isolated radial head fractures and those treated for radial head fractures in

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Section: Introductionmentioning

confidence: 99%

Open Reduction and Internal Fixation of Radial Head Fractures: Do Outcomes Differ Between Simple and Complex Injuries?

Pike

Grewal

Athwal

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Comminuted radial head fractures are complex elbow injuries. Of Mason type III radial head fractures, 75 % are associated with further ligamentous and osseous damage [7,12,23] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation

Katthagen

Jensen

Lill

et al. 2012

International Orthopaedics (SICOT)

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Purpose Dislocations of components, loosening of the stem, overstuffing and removal in up to 24 % of common radial head prostheses (RHP) after implantation in complex elbow injuries signal the need for improvement. The latest biomechanical evidence shows advantages for monopolar designs. Clinical results after primary and secondary implantation of the newly designed press-fit monobloc monopolar RHP in cases of complex elbow injury are evaluated. Methods Twenty-nine patients [median age 60 years (29-86)] were followed up retrospectively for a median of 25 months (7-54) post-operatively. Subjective parameters, the Mayo Elbow Performance Score (MEPS), the Broberg and Morrey score (BMS), latest radiographs and complications were evaluated. Results MEPS and BMS averaged 87.2±12.9 and 81.1±11.9 points, respectively. No case of implant loosening was observed; the RHP had to be removed in one case (3 %). The overall complication and revision rate was higher after secondary (53 %) than after primary (19 %) implantation. Conclusions Satisfactory clinical results and low short-term removal rates emphasise the practicality of monobloc monopolar RHP. Differentiated treatment of complex elbow fracturedislocations is compulsory to avoid the need for secondary RHP implantation which carries a higher complication rate.

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“…Excision can also be considered in patients with isolated, displaced comminuted radial head fractures that are not amenable to fixation [2] . Most comminuted radial head fractures, however, are not isolated [22] , and therefore excision alone is often contraindicated. Choosing to re-establish radio-capitellar mechanics [20] in Mason type 3 fractures by radial head arthroplasty or to preserve the radial head by internal fixation techniques remains controversial.…”

Section: Discussionmentioning

confidence: 99%

“…None of the studies identified in this systematic review gave this important baseline patient information. Recent studies have discussed the principles that guide decision-making in the management of comminuted radial head fractures [2,22,27] . Pike et al [2] recommended ORIF when feasible for all displaced (> 2 mm) radial head fractures consisting of less than four fragments.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Fixation Versus Replacement for Comminuted Radial Head Fractures in Adults: A Systematic Review

Patel

Rashid

2016

International Journal of Orthopaedics

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AIM:The purpose of this systematic review was to search for and critically appraise articles directly comparing functional outcomes and complications for fixation (ORIF) versus arthroplasty for comminuted radial head fractures (Mason type 3) in adults. MATERIAL AND METHODS: A comprehensive search of Medline, Embase and Cochrane databases using specific search terms and limits was conducted. Strict eligibility criteria were applied to stringently screen resultant articles. Three comparative studies were identified and reviewed. RESULTS: Two studies found significantly better functional scores after replacement compared with ORIF in Mason type 3 fractures. The third study found no significant differences in functional score or range of motion, but did find that grip strength was better after ORIF. Complication rates were too heterogenous for conclusion. issn.2311-5106.2016.03.164 International Journal of Orthopaedics considered if this is not possible. Further randomised comparative trials are required to clarify the decision-making between fixation and replacement. Functional outcomes and complications were conflicting in the studies included here. Ideally, treatment decision should take into account elbow stability and degree of comminution.

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Documentation of Associated Injuries Occurring With Radial Head Fracture

Cited by 139 publications

References 35 publications

Open Reduction and Internal Fixation of Radial Head Fractures: Do Outcomes Differ Between Simple and Complex Injuries?

Open Reduction and Internal Fixation of Radial Head Fractures: Do Outcomes Differ Between Simple and Complex Injuries?

Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation

Functional Outcomes of Fixation Versus Replacement for Comminuted Radial Head Fractures in Adults: A Systematic Review

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