Outcomes of radial head fractures treated with pre-curved metacarpal plate

Abstract

Objective To explore the clinical outcomes of MasonII/III radial head fractures without the neck involvement treated with pre-curved metacarpal plates. Methods Ninety cases of Mason typeII/III radial head fractures without the neck involvement were retrospectively collected from the department of orthopaedics of our hospital from September 2015 to May 2021. Group A (n = 44) underwent open reduction and internal fixation with pre-curved metacarpal plate, and Group B (n = 46) were fixed by traditional T-shaped plates. The operation time and the incision length were recorded during the operation. The Mayo Elbow Performance Score (MEPS), Disability of Arm, Shoulder and Hand (DASH) score, visual analogue scale (VAS) for pain, range of motion (ROM) and post-operative complications were evaluated at the last follow-up. Results All the patients were followed up for at least 12 months. There were no significant difference between two groups regarding operation time (54.2 ± 12.1 v.s 51.3 ± 7.2, mins), MEPS (88.9 ± 4.2 v.s 87.8 ± 4.4), DASH score (7.3 ± 4.6 v.s 9.0 ± 4.0), VAS (1.6 ± 0.8 v.s 1.7 ± 0.7), and ROM. However, the incision length was shorter in Group A (5.6 ± 0.5 v.s 6.6 ± 0.5, cm, P < 0.01). The postoperative complication rate was also lower in Group A (1/44 v.s 8/46, P = 0.02). Conclusion Masson II/III radial head fractures without the neck involvement treated with pre-curved metacarpal plates could achieve satisfactory outcomes comparable to traditional T-shaped plates. Moreover, the invasiveness and postoperative complications are less in patients with pre-curved metacarpal plates. Level of evidence III, retrospective comparison study.

Biomechanical comparison of different internal fixation devices for transversely unstable Mason type II radial head fractures

“…Maintaining the stability of radial head fractures remains a challenge for orthopedic surgeons due to the potential to cause problems such as combined elbow injuries ( Mellema et al, 2016 ). Studies have shown that a MTP and HCCs have favorable biomechanical outcomes in fixing axially unstable radial head fractures ( Demiroglu et al, 2016 ; Yang et al, 2023 ; Zhang et al, 2023 ). However, it is uncertain whether MTP or HCCSs have a biomechanical advantage in fixing transversely unstable radial head fractures.…”

“…The incidence of complications such as internal fixation failure ( Xu et al, 2020 ) and fracture nonunion ( Golinvaux et al, 2020 ) remain high, and the initial stability of the fracture break is one of the main influencing factors. In the past, such fractures were fixed with plates, especially mini-T plates (MTPs), because of their small size, thin plate surface, and simple application ( Yang et al, 2023 ). Moreover, plates have been shown to lead to favorable biomechanical outcomes in the treatment of axially unstable radial head fractures ( Yang et al, 2023 ).…”

“…In the past, such fractures were fixed with plates, especially mini-T plates (MTPs), because of their small size, thin plate surface, and simple application ( Yang et al, 2023 ). Moreover, plates have been shown to lead to favorable biomechanical outcomes in the treatment of axially unstable radial head fractures ( Yang et al, 2023 ). Recently, headless compression cannulated screws (HCCSs) have been used for the treatment of M2RFs because of their advantages such as greater fixation strength and unrestricted fixation position ( Al-Tawil and Arya, 2021 ; Gray et al, 2022 ).…”