Open Reduction and Internal Fixation of Radial Head Fractures

King, Graham J.W.; Evans, D. C.; Kellam, James F

doi:10.1097/00005131-199103000-00004

Cited by 187 publications

(100 citation statements)

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“…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]. In addition to the particular characteristics of the radial head fracture, associated injuries may influence treatment selection.…”

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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“…Stable reconstruction of all the fractures and associated soft-tissue injuries near the elbow joint is a prerequisite to start immediate postoperative physiotherapy and motion exercise in order to avoid stiffening (22,45,47,53,72,76). Poor results are directly related to immobilization periods longer than 3 to 4 weeks (61).…”

Section: Discussionmentioning

confidence: 99%

“…1) a stable reconstruction by means of internal fixation is a prerequisite ( fig. 2) to allow immediate mobilization and preven stiffness of the elbow joint (22,45,47,53,76). This can be achieved by the use of small fragment screws (22,24,45,76), Herbert screws (22,45,58), plate and screws (22,24), and resorbable polyglycolid pins (35) .…”

Section: Treatmentmentioning

confidence: 99%

Current Concepts Review

Harcke¹,

Kumar²

1991

Journal of Pediatric Orthopaedics

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The treatment of simple radial head fractures type Mason-Hotchkiss 1 and 2 is unequivocal. In the case of a displacement of less than 2 mm (MasonHotchkiss 1), functional conservative treatment is indicated. If the displacement is more than 2 mm (Mason-Hotchkiss 2) internal fixation is indicated, combined with treatment of the soft-tissue injuries. The treatment of comminuted radial head fractures Mason-Hotchkiss type 3 is more controversial, as they are usually associated with ligament injuries. Conservative treatment appears to have unsatisfactory results. Opinions differ on surgical treatment, i.e. 1) excision of the radial head ; 2) reconstruction by means of internal fixation ; 3) excision and reconstruction with a prosthesis. Basic experimental research on human cadaver elbows shows the importance of the conservation of the radial head, especially in case of associated soft tissue injuries. In most cases a stable osteosynthesis is impossible, and in case of associated ligament disruptions, resection and reconstruction by means of a rigid radial head prosthesis should be considered. Experimental research demonstrates promising results for rigid radial head prostheses in human cadaver elbows with a resected radial head and failing medial collateral ligament. Short-term clinical studies seem to confirm this, but long-term results are as yet unknown.

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“…Type 3 fractures continue to be treated operatively and general consensus agrees with this approach, despite the paucity of data confirming improved outcomes with surgical management [14]. Type 2 fractures have been treated nonoperatively with excellent results in one series [4]; however, other authors have reported very good results with operative treatment [8].…”

Section: Validationmentioning

confidence: 99%