Short term outcome of radial head arthroplasty in Mason type 3 and 4 fractures

Authors

  • Mudasir Rashid Ganai Department of Orthopaedics, SKIMS MC and H, Srinagar, India
  • Shahid Shabir Khan Department of Orthopaedics, SKIMS MC and H, Srinagar, India
  • Inayat Rahim Department of Orthopaedics, SKIMS MC and H, Srinagar, India
  • Saheel Maajid Department of Orthopaedics, SKIMS MC and H, Srinagar, India
  • Tahir Ahmed Dar Department of Orthopaedics, SKIMS MC and H, Srinagar, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20212431

Keywords:

Mason classification, Radial head arthroplasty, Mayo elbow performance

Abstract

Background: Radial head arthroplasty provides a suitable treatment in Mason type 3 and 4 3 fractures. Arthroplasty produces consistent results with a shorter learning curve than ORIF and prevents the late complications associated with radial head excision.

Methods: After seeking approval from local institutional ethical committee 30 patients with Mason type 3 and 4 radial head fractures were admitted from outpatient department (OPD) of SKIMS MC and Hospital Bemina, Srinagar. The study was conducted from February 2019 to June 2020 in department of Orthopaedics SKIMS MC and Hospital Bemina, Srinagar. 30 patients with mean age of 25 years comprising of 9 females and 21 males underwent radial head arthroplasty and were followed up to a minimum of 1 year post-operatively.

Results: Outcome was evaluated by assessing elbow functional performance using Mayo elbow performance (MEPI). No revisions were performed during the study. Two patients had implant backout and 6 patients had elbow stiffness.

Conclusions: Radial head arthroplasty can be used successfully with most of excellent results for treatment of comminuted radial head fracture (Mason type III and IV radial head fractures). Over all radial head arthroplasty is a demanding option in type 3 and type 4 fractures which are not amenable to reconstruction.

References

Furry KL, Clinkscales CM. Comminuted fractures of the radial head: arthroplasty versus internal fixation. Clin Orth Rel Res. 1998;353:40-52.

Morrey BF. Radial head fracture. In: The elbow and its disorders. Morrey BF, ed. 3rd ed. Philadelphia: WB Saunders. 2000;341-64.

Mason ML. Some observations on fracture of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42:123-32.

Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK. Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg. 2004;86A:1925-30.

Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: A long-term review. J Trauma. 2001;50(1):46-52.

Smith MV, Calfee RP, Baumgarten KM, Brophy RH, Wright RW. Upper extremity-specific measures of disability and outcomes in orthopaedic surgery. J Bone Joint Surg Am. 2012;94(3):277-85.

Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am. 1986;68(5):669-74.

Morrey BF, An KN. Articular and ligamentous contribution to the stability of the elbow joint. J Sports Med. 1983;11:315-9.

Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63(6):872-7.

Bain GI, Ashwood N, Baird R, Unni R. Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. Surgical technique. J Bone Joint Surg Am. 2005;87(1):136.

Choudhary BM. Is radial head resection a menace for the clinical outcomes of the elbow for communited radial head fractures? Int J TRes Orthop. 2019;(1):70-6.

Ikeda M, Yamashina Y, Kamimoto M. Open reduction and internal fixation of comminuted fractures of the radial head using lowprofile mini-plates. J Bone Joint Surg Br. 85:1040-4.

Dotzis A, Cochu G, Mabit C. Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis. J Bone Joint Surg Br. 2006;88:760-4.

Businger A, Ruedi TP, Sommer C. On-table reconstruction of comminuted fractures of the radial head. Injury. 2010;41:583-8.

Goldberg I, Peylan J, Yosipovitch Z. Late results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am. 1986;68:675-9.

Fuchs S, Chylarecki C. Do functional deficits result from radial head resection? J Shoulder Elbow Surg. 1999;8:247-51.

Iftimie PP, Garcia CJ, Forcada GLI, Pedrouzo GJE, Gomà GJ. Resection arthroplasty for radial head fractures: long-term follow-up. J Shoulder Elbow Surg. 2011;20:45-50.

Yalcinkaya M, Bagatur AE, Erdogan S, Zorer G. Resection arthroplasty for mason type iii radial head fractures yield good clinical but poor radiological results in the long-term. J Orthop. 2013;36(11):1358-64.

King GJW, Faber KJ. Post Traumatic Elbow Stiffness. Orthop Clin N Am. 2000;31:129-14.

Paschos NK, Mitsionis GI, Vasiliadis HS, Georgoulis AD. Comparison of Early Mobilization Proto-cols in Radial Head Fractures. J Orthop Trauma. 2013;27:134-9.

Harding P, Rasekaba T, Smirneos L, Holland AE. Early Mobilisation for Elbow Fractures in Adults. In: The Cochrane Collaboration and P. Harding, Eds., Cochrane Database of Systematic Reviews. Chichester: John Wiley & Sons, Ltd. 2011.

Downloads

Published

2021-06-23

Issue

Section

Original Research Articles