Radial shortening following a fracture of the proximal radius

Duckworth, Andrew D.; Watson, Bruce S.; Will, E.; Petrisor, Brad; Walmsley, P; Court-Brown, Charles M.; McQueen, Margaret M.

doi:10.3109/17453674.2011.574563

Cited by 25 publications

(21 citation statements)

References 27 publications

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“…The only poor result was experienced by the patient who underwent a RH excision. Duckworth [ 25 ] retrospectively reviewed 60 patients affected by RH fracture, identifying 22 patients with radio-ulnar discrepancy. The good short term results (6 months) even after conservative management are to be considered non indicative, since usually patients experience a later worsening and no indication is reported about IOM assessment.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of acute Essex-Lopresti injury: focus on terminology and review of literature

Fontana

Cavallo

Bettelli

et al. 2018

BMC Musculoskelet Disord

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BackgroundAcute Essex-Lopresti injury is a rare and disabling condition of longitudinal instability of the forearm. When early diagnosed, patients report better outcomes with higher functional recovery. Aim of this study is to focus on the different lesion patterns causing forearm instability, reviewing literature and the cases treated by the Authors and to propose a new terminology for their identification.MethodsFive patients affected by acute Essex-Lopresti injury have been enrolled for this study. ELI was caused in two patients by bike fall, two cases by road traffic accident and one patient by fall while walking. A literature search was performed using Ovid Medline, Ovid Embase, Scopus and Cochrane Library and the Medical Subject Headings vocabulary. The search was limited to English language literature. 42 articles were evaluated, and finally four papers were considered for the review.ResultsAll patients were operated in acute setting with radial head replacement and different combinations of interosseous membrane reconstruction and distal radio-ulnar joint stabilization. Patients were followed for a mean of 15 months: a consistent improvement of clinical results were observed, reporting a mean MEPS of 92 and a mean MMWS of 90.8. One case complained persistent wrist pain associated to DRUJ discrepancy of 3 mm and underwent ulnar shortening osteotomy nine months after surgery, with good results.DiscussionThe clinical studies present in literature reported similar results, highlighting as patients properly diagnosed and treated in acute setting report better results than patients operated after four weeks. In this study, the definitions of “Acute Engaged” and “Undetected at Imminent Evolution” Essex-Lopresti injury are proposed, in order to underline the necessity to carefully investigate the anatomical and radiological features in order to perform an early and proper surgical treatment.ConclusionsFollowing the observations, the definitions of “Acute Engaged” and “Undetected at Imminent Evolution” injuries are proposed to distinguish between evident cases and more insidious settings, with necessity of carefully investigate the anatomical and radiological features in order to address patients to an early and proper surgical treatment.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of acute Essex-Lopresti injury: focus on terminology and review of literature

Fontana

Cavallo

Bettelli

et al. 2018

BMC Musculoskelet Disord

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“…The interosseous membrane is an important stabilizer during axial loads on the forearm, and lesions are often not recognized. 20,21 Mason type I radial head fractures cause an intra-articular hematoma that limits the elbow range of motion (ROM). The elbow extension test uses this phenomenon to rule out intra-articular fractures of the elbow: an elbow that can be fully extended is unlikely to be fractured.…”

Section: Diagnosticsmentioning

confidence: 99%

Mason Type I Fractures of the Radial Head

Keizer¹,

Walenkamp²,

Goslings³

et al. 2015

Orthopedics

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Mason type I fractures are the most common fractures of the radial head. The fractures have a benign character and often result in good, pain-free function. Nevertheless, up to 20% of patients with a Mason type I fracture report loss of extension and residual pain. Currently, there is a lack of consensus concerning diagnosis and treatment of these fractures. The goal of this study was to systematically review incidence, diagnosis, classification, treatment, and outcome of Mason type I radial head fractures in adults and establish an evidence-based treatment guideline. A search of the MEDLINE, EMBASE, and Cochrane databases was conducted for English titles without restrictions on publication date. The authors included titles that addressed Mason type I radial head fractures and covered incidence, diagnostics, treatment, or functional or patient-related outcome. Included were randomized controlled trials; case-control studies; comparative cohort studies; case series with more than 10 patients; and expert opinions. Reference lists were cross-checked for additional titles. The search yielded 1734 studies, of which 95 met the inclusion criteria. Seven studies showed that the elbow extension test has a high sensitivity (88.0-97.6) to rule out Mason type I radial head fractures. If radiography is required, antero-posterior and lateral radiographs suffice. For pain relief, hematoma aspiration seems safe and effective. Mason type I fractures are best treated with 48 hours of rest with a sling, followed with active mobilization. Cast immobilization should be avoided. Mobilization should be encouraged and if needed supported by physical therapy.

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“…Nineteen of 22 patients had very favourable results. It was suggested that upwards of 30% of all persons with closed radial head fractures display evidence of an Essex‐Lopresti injury [17]. Their study highlights the need for clear definition of what constitutes a clinically important IOM injury because many individuals may have mild or partial injuries that go on to heal with minimal consequence [17,23].…”

Section: Detecting Longitudinal Instabilitymentioning

confidence: 99%